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NPI Code Detail

MEDICARE: ADESUWA LILLIAN OBASOGIE NURSE PRACTITIONER

MEDICARE: ADESUWA LILLIAN OBASOGIE NURSE PRACTITIONER
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner2007024270MO

General Provider Information

NPI Number : 1518687110
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADESUWA LILLIAN OBASOGIE NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 2323 E 63RD ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64130-3462
Country : US
Telephone Number : 816-217-2076
Fax Number :
Provider Business Practice Location Address
First Line : 2323 E 63RD ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64130-3462
Country : US
Telephone Number : 816-217-2076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2022
Last Update Date : 09/01/2022

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Directions to “ ADESUWA LILLIAN OBASOGIE NURSE PRACTITIONER” Practice Location

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