Healthcare Provider Details

I. General information

NPI: 1083374375
Provider Name (Legal Business Name): WOW HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2021
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 LILY CREEK RD STE 201
MIDDLETOWN KY
40243-2818
US

IV. Provider business mailing address

904 LILY CREEK RD STE 201
MIDDLETOWN KY
40243-2818
US

V. Phone/Fax

Practice location:
  • Phone: 502-357-3900
  • Fax:
Mailing address:
  • Phone: 502-357-3900
  • Fax: 502-323-0377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PRISCILLA N OWUSU
Title or Position: PHYSICIAN
Credential: MD
Phone: 203-805-2751