Provider Demographics
NPI:1093093262
Name:OWHE, OLUTOYIN TITILAYO
Entity Type:Individual
Prefix:DR
First Name:OLUTOYIN
Middle Name:TITILAYO
Last Name:OWHE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:OLUTOYIN
Other - Middle Name:TITILAYO
Other - Last Name:FAMUYIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDIV, MHA, RN
Mailing Address - Street 1:328 CUMBERLAND ST W
Mailing Address - Street 2:
Mailing Address - City:COWAN
Mailing Address - State:TN
Mailing Address - Zip Code:37318-3112
Mailing Address - Country:US
Mailing Address - Phone:931-691-3102
Mailing Address - Fax:931-962-9911
Practice Address - Street 1:328 CUMBERLAND ST W
Practice Address - Street 2:
Practice Address - City:COWAN
Practice Address - State:TN
Practice Address - Zip Code:37318-3112
Practice Address - Country:US
Practice Address - Phone:931-962-3102
Practice Address - Fax:931-962-9911
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000180865163W00000X
TN0000002140163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163W00000XNursing Service ProvidersRegistered Nurse