Provider Demographics
NPI:1801383344
Name:OMOREGIE, FAITH ITOHAN (RN)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:ITOHAN
Last Name:OMOREGIE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:FAITH
Other - Middle Name:ITOHAN
Other - Last Name:OMOREGIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:7500 W 151ST ST UNIT 23396
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66283-1423
Mailing Address - Country:US
Mailing Address - Phone:913-620-5055
Mailing Address - Fax:
Practice Address - Street 1:7500 W 151ST ST UNIT 23396
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66283-1423
Practice Address - Country:US
Practice Address - Phone:913-620-5055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017034843163WC0400X
KS13-135288-051163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management