Healthcare Provider Details

I. General information

NPI: 1245674456
Provider Name (Legal Business Name): NNEKA ADAEZE OGBU RN/BSN/MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NNEKA CORDELIA OGBU

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 E GRANT ST APT. 311
MINNEAPOLIS MN
55404-1400
US

IV. Provider business mailing address

515 E GRANT ST APT. 311
MINNEAPOLIS MN
55404-1400
US

V. Phone/Fax

Practice location:
  • Phone: 612-644-4490
  • Fax:
Mailing address:
  • Phone: 612-644-4490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberR 156043-9
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: