Provider Demographics
NPI:1356450472
Name:OJIKUTU, GUILENE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:GUILENE
Middle Name:
Last Name:OJIKUTU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:GUILENE
Other - Middle Name:
Other - Last Name:NICOLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1071 PENN CIR
Mailing Address - Street 2:APT. G-414
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1165
Mailing Address - Country:US
Mailing Address - Phone:401-374-7249
Mailing Address - Fax:
Practice Address - Street 1:1400 BLACKHORSE HILL RD
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-2040
Practice Address - Country:US
Practice Address - Phone:610-384-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052268363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical