Healthcare Provider Details

I. General information

NPI: 1720869027
Provider Name (Legal Business Name): OPEOLUWA AWE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 S SHERIDAN ST
WICHITA KS
67213-2432
US

IV. Provider business mailing address

216 S SHERIDAN ST
WICHITA KS
67213-2432
US

V. Phone/Fax

Practice location:
  • Phone: 316-208-4898
  • Fax:
Mailing address:
  • Phone: 316-208-4898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: