Provider Demographics
NPI:1083332654
Name:BISIOLU-KING, ENIOLA
Entity type:Individual
Prefix:
First Name:ENIOLA
Middle Name:
Last Name:BISIOLU-KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3157 FARNAM ST APT 7207
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-3529
Mailing Address - Country:US
Mailing Address - Phone:732-710-0566
Mailing Address - Fax:
Practice Address - Street 1:4350 EMILE ST
Practice Address - Street 2:984185 NEBRASKA MEDICAL CENTER
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131
Practice Address - Country:US
Practice Address - Phone:000-000-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program