Provider Demographics
NPI:1194248666
Name:OSAKWE, FAVOR (PMHNP-BC, FNP, APRN)
Entity type:Individual
Prefix:
First Name:FAVOR
Middle Name:
Last Name:OSAKWE
Suffix:
Gender:F
Credentials:PMHNP-BC, FNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S JEFFERSON ST STE 204
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-3142
Mailing Address - Country:US
Mailing Address - Phone:862-764-9619
Mailing Address - Fax:
Practice Address - Street 1:400 S JEFFERSON ST STE 204
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-3142
Practice Address - Country:US
Practice Address - Phone:862-764-9619
Practice Address - Fax:832-585-1651
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134340363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily