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Individual
LYDIAH OTACHI
Active
Individual
LYDIAH OTACHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
11498
MN
363LG0600X
Gerontology Nurse Practitioner
11498
MN
363LP2300X
Primary Care Nurse Practitioner
Primary
11498
MN
Other
Enumeration date
04/12/2024
Last updated
09/21/2026
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