Provider Demographics
NPI:1366159881
Name:MIWA SALDIVAR, OYUKI (FNP-BC)
Entity type:Individual
Prefix:
First Name:OYUKI
Middle Name:
Last Name:MIWA SALDIVAR
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4060 FAUDREE RD., SUITE 104A, #413
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765
Mailing Address - Country:US
Mailing Address - Phone:432-653-3106
Mailing Address - Fax:
Practice Address - Street 1:3401 GREENBRIAR STE 200
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-4653
Practice Address - Country:US
Practice Address - Phone:432-618-5215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX928098363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner