Provider Demographics
NPI:1780480343
Name:IKO, AFIWA IMULE NATEBA I
Entity type:Individual
Prefix:MISS
First Name:AFIWA
Middle Name:IMULE NATEBA
Last Name:IKO
Suffix:I
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9325 BEMIS PLZ APT 4
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2463
Mailing Address - Country:US
Mailing Address - Phone:402-319-6723
Mailing Address - Fax:
Practice Address - Street 1:9325 BEMIS PLZ APT 4
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2463
Practice Address - Country:US
Practice Address - Phone:402-319-6723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide