Provider Demographics
NPI:1366117012
Name:ERIMWIOGHAE, STEVE OSASERE (APRN)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:OSASERE
Last Name:ERIMWIOGHAE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2101 BLAKEHILL DR
Mailing Address - Street 2:
Mailing Address - City:HEARTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75126-8410
Mailing Address - Country:US
Mailing Address - Phone:347-837-7480
Mailing Address - Fax:
Practice Address - Street 1:9218 KIMMER DR STE 200
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6733
Practice Address - Country:US
Practice Address - Phone:303-683-5620
Practice Address - Fax:303-683-5609
Is Sole Proprietor?:No
Enumeration Date:2021-08-14
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1050445363LP0808X
COC-APN.0100313-C-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health