Individual
ISIDORE OBINNA NWAGWU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
200 E CENTENNIAL DR, # 3&4, PITTSBURG, KS 66762-6571
(620) 231-9873
(620) 231-5062
Mailing address
200 E CENTENNIAL DR, # 3&4, PITTSBURG, KS 66762-6571
(620) 231-9873
(620) 231-5062
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2011039961
MO
363LF0000X
Family Nurse Practitioner
Primary
53-75487-021
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201071080A
—
KS
Enumeration date
12/28/2011
Last updated
07/21/2022
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