Healthcare Provider Details

I. General information

NPI: 1881491306
Provider Name (Legal Business Name): ORUARO NELSON IDUDHE RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W HILL BLVD
CHARLESTON SC
29404-4704
US

IV. Provider business mailing address

204 W HILL BLVD
CHARLESTON SC
29404-4704
US

V. Phone/Fax

Practice location:
  • Phone: 773-600-2845
  • Fax:
Mailing address:
  • Phone: 773-600-2845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number821227
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number821227
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number821227
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number821227
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: