Provider Demographics
NPI:1346565900
Name:OSUALA, FAVOUR OGECHUKWU (RN)
Entity Type:Individual
Prefix:MS
First Name:FAVOUR
Middle Name:OGECHUKWU
Last Name:OSUALA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CHINWENDU
Other - Middle Name:OGECHUKWU
Other - Last Name:UGWOEGBU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4974 N 91ST ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-4127
Mailing Address - Country:US
Mailing Address - Phone:414-527-1877
Mailing Address - Fax:
Practice Address - Street 1:4974 N 91ST ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-4127
Practice Address - Country:US
Practice Address - Phone:414-527-1877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI167123-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse