Provider Demographics
NPI:1760132369
Name:NYAKUNDI, GEORGE OSEKO (MSN,PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:OSEKO
Last Name:NYAKUNDI
Suffix:
Gender:M
Credentials:MSN,PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9415 E HARRY ST STE 503
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-5082
Mailing Address - Country:US
Mailing Address - Phone:316-570-1684
Mailing Address - Fax:316-669-9602
Practice Address - Street 1:9415 E HARRY ST STE 503
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-5082
Practice Address - Country:US
Practice Address - Phone:316-570-1684
Practice Address - Fax:316-669-9602
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS81079363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health