Provider Demographics
NPI:1093545683
Name:ODUOR, NONI
Entity type:Individual
Prefix:MS
First Name:NONI
Middle Name:
Last Name:ODUOR
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 1:7426 W 140TH ST APT 601
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-4284
Mailing Address - Country:US
Mailing Address - Phone:913-980-2791
Mailing Address - Fax:
Practice Address - Street 1:7426 W 140TH ST APT 601
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-4284
Practice Address - Country:US
Practice Address - Phone:913-980-2791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-83446-102363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care