Individual
ENIOLA OLUWATOSIN FAWIBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
7333 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6280
(260) 458-3830
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
(260) 266-6013
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28232019A
IN
363L00000X
Nurse Practitioner
Primary
71006932A
IN
363LF0000X
Family Nurse Practitioner
71006932A
IN
Other
Enumeration date
02/08/2017
Last updated
10/10/2022
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