Provider Demographics
NPI:1740071604
Name:OSSO, IKHLAS
Entity type:Individual
Prefix:
First Name:IKHLAS
Middle Name:
Last Name:OSSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 N 70TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-1906
Mailing Address - Country:US
Mailing Address - Phone:402-510-1630
Mailing Address - Fax:
Practice Address - Street 1:1445 N 70TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-1906
Practice Address - Country:US
Practice Address - Phone:402-510-1630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide