Provider Demographics
NPI:1134841117
Name:MAGAKOU, SIDOINE MICHELE (PMH-NP)
Entity type:Individual
Prefix:
First Name:SIDOINE
Middle Name:MICHELE
Last Name:MAGAKOU
Suffix:
Gender:F
Credentials:PMH-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15626 S GALLERY ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-7706
Mailing Address - Country:US
Mailing Address - Phone:913-548-7961
Mailing Address - Fax:
Practice Address - Street 1:2675 S ABILENE ST STE 100
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2363
Practice Address - Country:US
Practice Address - Phone:720-507-4779
Practice Address - Fax:833-941-5047
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS81528363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health