MEDICARE: DAWN MICHELLE ONAEKO FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	3013607	KY

General Provider Information

NPI Number	:	1033727920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN MICHELLE ONAEKO FNP

Provider Business Mailing Address
First Line	:	3901 RAPID RUN DR APT 504
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40515-1880
Country	:	US
Telephone Number	:	832-339-0831
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 RAPID RUN DR APT 504
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40515-1880
Country	:	US
Telephone Number	:	832-339-0831
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2020
Last Update Date	:	07/17/2020

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