Provider Demographics
NPI:1780945444
Name:SAKWE, GLADYS
Entity type:Individual
Prefix:
First Name:GLADYS
Middle Name:
Last Name:SAKWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 SOUTHWEST 28TH STREET APT 11
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72713
Mailing Address - Country:US
Mailing Address - Phone:240-474-3469
Mailing Address - Fax:240-474-3469
Practice Address - Street 1:2964 MARTIN LUTHER KING JUNIOR BOULEVARD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704
Practice Address - Country:US
Practice Address - Phone:479-521-5103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide