Jegede, Ibukunola Charles

Jegede, Ibukunola Charles is an individual health care provider with primary practice located at 17500 Burke St , Omaha NE 68118-2244. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Jegede, Ibukunola Charles can be contacted via phone (402) 401-3566.

Contact Information

Primary practice address
17500 Burke St Omaha NE 68118-2244
Phone: (402) 401-3566
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 561 Nebraska

Profile Details

NPI number 1508087206
LBN Legal business name Jegede, Ibukunola Charles
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2007
Last updated Nov 28th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508087206 NPPES
Nebraska MEDICAID 1417045642

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