Provider Demographics
NPI:1679289730
Name:OMIGIE, OMOZUWA VALENTINA (APRN)
Entity type:Individual
Prefix:
First Name:OMOZUWA
Middle Name:VALENTINA
Last Name:OMIGIE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7381 W 133RD ST STE 401
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4776
Mailing Address - Country:US
Mailing Address - Phone:913-346-0000
Mailing Address - Fax:916-361-0000
Practice Address - Street 1:7381 W 133RD ST STE 401
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-4776
Practice Address - Country:US
Practice Address - Phone:913-346-0000
Practice Address - Fax:913-361-0000
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-81132-021363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health