Provider Demographics
NPI:1699537308
Name:GIFTEDHAND HEALTHCARE SERVICES
Entity type:Organization
Organization Name:GIFTEDHAND HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:OLUFUNKE
Authorized Official - Middle Name:PATIENCE
Authorized Official - Last Name:MOMOH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:260-237-6588
Mailing Address - Street 1:12423 STONEBORO CT
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-9570
Mailing Address - Country:US
Mailing Address - Phone:260-237-6588
Mailing Address - Fax:
Practice Address - Street 1:12423 STONEBORO CT
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-9570
Practice Address - Country:US
Practice Address - Phone:260-237-6588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty