Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 59-79171-121 | KS |
N | 363LA2200X | Nurse Practitioner - Adult Health | 59-79171-121 | KS |
N | 363LG0600X | Nurse Practitioner - Gerontology | 59-79171-121 | KS |
NPI | 1033759923 |
---|---|
Provider Name | Peter Onyinkwa Ogao |
First Address | Olathe, KS 66062-1358 |
Second Address | Kansas City, MO 64128-2226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2020 |
Last Update Date | 09/01/2020 |