Individual
MR. KODJO SENIOR EDOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
8623 E 32ND ST N, WICHITA, KS 67226-3317
(316) 869-2888
(316) 425-5550
Mailing address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(208) 571-8623
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
150820
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
83479
KS
Other
Enumeration date
03/08/2023
Last updated
12/06/2024
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