Provider Demographics
NPI:1609660067
Name:AWOUMA BILOUNGA, TAPITA MAEVA
Entity type:Individual
Prefix:
First Name:TAPITA MAEVA
Middle Name:
Last Name:AWOUMA BILOUNGA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 N 160TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-8032
Mailing Address - Country:US
Mailing Address - Phone:240-781-8877
Mailing Address - Fax:
Practice Address - Street 1:4655 N 160TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-8032
Practice Address - Country:US
Practice Address - Phone:240-781-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide