Healthcare Provider Details

I. General information

NPI: 1124424460
Provider Name (Legal Business Name): EVELYN CHINONYE ONYEJI DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2014
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7406 FULLERTON ST
JACKSONVILLE FL
32256-3552
US

IV. Provider business mailing address

14091 JOMATT LOOP
WINTER GARDEN FL
34787-0115
US

V. Phone/Fax

Practice location:
  • Phone: 904-538-0440
  • Fax:
Mailing address:
  • Phone: 407-715-4998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9290974
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9290974
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: