Provider Demographics
NPI:1710580998
Name:MIKALE, ALEDIA (CD)
Entity Type:Individual
Prefix:MRS
First Name:ALEDIA
Middle Name:
Last Name:MIKALE
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5519 N 69TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-1508
Mailing Address - Country:US
Mailing Address - Phone:402-881-0281
Mailing Address - Fax:
Practice Address - Street 1:5519 N 69TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-1508
Practice Address - Country:US
Practice Address - Phone:402-881-0281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula