Healthcare Provider Details

I. General information

NPI: 1407010499
Provider Name (Legal Business Name): CHARITY NJOKU LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4498 STONECASTLE DR APT. 203
DAYTON OH
45440-3191
US

IV. Provider business mailing address

4498 STONECASTLE DR APT. 203
DAYTON OH
45440-3191
US

V. Phone/Fax

Practice location:
  • Phone: 937-320-9066
  • Fax:
Mailing address:
  • Phone: 937-320-9066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN 126360
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: