Individual
MR. EDI KOFFI ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4205 S 96TH ST, OMAHA, NE 68127-1259
(531) 466-1275
(531) 242-4429
Mailing address
6623 N 102ND AVE, OMAHA, NE 68122-3018
(402) 981-1920
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
69402
NE
Other
Enumeration date
03/12/2025
Last updated
03/12/2025
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