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General NPI Number Information
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NPI Number | 1891689147
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Entity Type | Individual
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Provider Name | OMOWUNMI GRACE OKE
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Gender | Female
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 5503 NIGHTHAWK WAY
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-4771
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Country | US
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Telephone | 317-640-1713
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Fax | 877-781-5107
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Provider Business Mailing Address
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Address Line | 5503 NIGHTHAWK WAY
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-4771
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Country | US
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Telephone | 317-640-1713
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Fax | 877-781-5107
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number | 24-018334-1
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License Number State | IN
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