Provider Demographics
NPI:1881288116
Name:OLOTU, OLIVER SAIMON
Entity type:Individual
Prefix:
First Name:OLIVER
Middle Name:SAIMON
Last Name:OLOTU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:OLIVER
Other - Middle Name:SAIMON
Other - Last Name:KIMATHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10235 GRANDVIEW ST APT A
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-4278
Mailing Address - Country:US
Mailing Address - Phone:913-709-7008
Mailing Address - Fax:913-499-6687
Practice Address - Street 1:10235 GRANDVIEW ST APT A
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-4278
Practice Address - Country:US
Practice Address - Phone:913-709-7008
Practice Address - Fax:913-499-6687
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS120944376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide