Healthcare Provider Details

I. General information

NPI: 1518820091
Provider Name (Legal Business Name): CLARITYACP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 FRANCIS PL APT 2N
SAINT LOUIS MO
63105-2426
US

IV. Provider business mailing address

810 FRANCIS PL APT 2N
SAINT LOUIS MO
63105-2426
US

V. Phone/Fax

Practice location:
  • Phone: 314-728-8287
  • Fax:
Mailing address:
  • Phone: 314-728-8287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. OGHOSA EVBUOMWAN
Title or Position: FOUNDER/CEO
Credential: MD, MPH, MBA
Phone: 314-728-8287