Provider Demographics
NPI:1982595740
Name:PRINCE, SUMIKO D (NURSE AIDE)
Entity type:Individual
Prefix:
First Name:SUMIKO
Middle Name:D
Last Name:PRINCE
Suffix:
Gender:F
Credentials:NURSE AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 JOHN A CREIGHTON BLVD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-3517
Mailing Address - Country:US
Mailing Address - Phone:402-378-5270
Mailing Address - Fax:
Practice Address - Street 1:11306 DAVENPORT ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2630
Practice Address - Country:US
Practice Address - Phone:402-884-1645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider