Omar, Radwa Clarissa

Omar, Radwa Clarissa is an individual health care provider with primary practice located at 3602 Cumberland Ave Ste B102 , Middlesboro KY 40965-2614. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Omar, Radwa Clarissa can be contacted via phone (606) 248-7778.

Contact Information

Primary practice address
3602 Cumberland Ave Ste B102 Middlesboro KY 40965-2614
Phone: (606) 248-7778
Fax: (606) 248-7787
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3008054 Kentucky

Profile Details

NPI number 1598102832
LBN Legal business name Omar, Radwa Clarissa
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2013
Last updated Jan 28th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598102832 NPPES
Kentucky MEDICAID MM3197527

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