=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013108901
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FELICIA ONUORAH RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2007
-----------------------------------------------------
Last Update Date | 01/15/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3113 EDGETONE DR
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27604-3703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-623-5050
-----------------------------------------------------
Fax | 919-878-5649
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3113 EDGETONE DR
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27604-3703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-850-2336
-----------------------------------------------------
Fax | 919-878-5649
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 311ZA0620X
-----------------------------------------------------
Taxonomy Name | Adult Care Home Facility
-----------------------------------------------------
License Number | MHL-092-535
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------