Provider Demographics
NPI:1629943394
Name:GAYIBOR, EDWIGE
Entity type:Individual
Prefix:
First Name:EDWIGE
Middle Name:
Last Name:GAYIBOR
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7717 S 185TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136-6562
Mailing Address - Country:US
Mailing Address - Phone:402-515-4611
Mailing Address - Fax:
Practice Address - Street 1:7717 S 185TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-6562
Practice Address - Country:US
Practice Address - Phone:402-515-4611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion