Provider Demographics
NPI:1548750250
Name:TOKUNBOH, ELIZABETH E (RN, WCC, DWC, CLT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:E
Last Name:TOKUNBOH
Suffix:
Gender:F
Credentials:RN, WCC, DWC, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 S HYDRAULIC ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-1908
Mailing Address - Country:US
Mailing Address - Phone:316-871-7079
Mailing Address - Fax:877-440-1864
Practice Address - Street 1:321 S HYDRAULIC ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-1908
Practice Address - Country:US
Practice Address - Phone:316-871-7079
Practice Address - Fax:877-440-1864
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13108220031163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse