Provider Demographics
NPI:1740169754
Name:AGBEDOR, YAWA
Entity type:Individual
Prefix:
First Name:YAWA
Middle Name:
Last Name:AGBEDOR
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 1:6305 READ ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68152-2234
Mailing Address - Country:US
Mailing Address - Phone:531-213-6568
Mailing Address - Fax:
Practice Address - Street 1:6305 READ ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68152-2234
Practice Address - Country:US
Practice Address - Phone:531-213-6568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider