RADWA CLARISSA OMAR APRN NPI 1598102832

NPI Information

  • NPI: 1598102832
  • Provider Name: RADWA CLARISSA OMAR, APRN
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3602 CUMBERLAND AVE STE B102
    MIDDLESBORO, KY
    ZIP 40965
  • Phone: (606) 248-7778

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NPI Details

Radwa Clarissa Omar, APRN is a family nurse practitioner in Middlesboro, KY with 12 years of experience. Radwa Clarissa Omar, APRN NPI is 1598102832. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: LINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduation Year:2013

The provider's business location address is:

3602 CUMBERLAND AVE STE B102
MIDDLESBORO, KY
ZIP 40965-614
Phone: (606) 248-7778
Fax: (606) 248-7787

The NPI 1598102832 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/28/2013 and was last updated on 1/28/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily3008054KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1MM3197527MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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