Individual
OLUWATAYO MWAMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
615 VINEYARDS CT, LAFAYETTE, IN 47905-3806
(317) 728-8917
Mailing address
615 VINEYARDS CT, LAFAYETTE, IN 47905-3806
(317) 728-8917
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
28273458A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
AC008400
MD
Other
Enumeration date
09/19/2024
Last updated
12/04/2025
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