Provider Demographics
NPI:1164227914
Name:KONMEGNE MAGAPTCHE, CLEMENT (CARE GIVER)
Entity type:Individual
Prefix:
First Name:CLEMENT
Middle Name:
Last Name:KONMEGNE MAGAPTCHE
Suffix:
Gender:M
Credentials:CARE GIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-2757
Mailing Address - Country:US
Mailing Address - Phone:402-202-5556
Mailing Address - Fax:
Practice Address - Street 1:8221 STOCKWELL ST # NE68506
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-4769
Practice Address - Country:US
Practice Address - Phone:402-202-5556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker