Provider Demographics
NPI:1164079539
Name:ONAIWU, SYLVESTER A (REGISTERED NURSE)
Entity Type:Individual
Prefix:MR
First Name:SYLVESTER
Middle Name:A
Last Name:ONAIWU
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 70TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-1003
Mailing Address - Country:US
Mailing Address - Phone:763-321-0541
Mailing Address - Fax:651-631-2538
Practice Address - Street 1:2108 70TH AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-1003
Practice Address - Country:US
Practice Address - Phone:763-321-0541
Practice Address - Fax:651-631-2538
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN389339251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health