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General NPI Number Information
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NPI Number | 1205602638
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Entity Type | Organization
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Legal Business Name | PRESTIGE HEALTH SERVICES PLLC
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Dates
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Enumeration Date | 11/27/2023
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 411 PARKWAY ST STE C
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City | GREENSBORO
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State | NC
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Zip | 27401-1644
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Country | US
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Telephone | 336-858-4625
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Fax |
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Provider Business Mailing Address
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Address Line | 411 PARKWAY ST STE C
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City | GREENSBORO
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State | NC
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Zip | 27401-1644
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Country | US
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Telephone | 336-858-4625
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ONYEJE IJAOLA
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Credential | FNP
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Telephone | 336-858-4625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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