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General NPI Number Information
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NPI Number | 1235729773
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Entity Type | Individual
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Provider Name | OGHENETEGIRI UREVBU APRN GAA- NP
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Gender | Female
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Dates
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Enumeration Date | 01/19/2021
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Last Update Date | 01/20/2021
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Provider Practice Location Address
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Address Line | PHILLIP'S PEDIATRICS, PC 455 S MAIN STREET, STE 103
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City | HINESVILLE
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State | GA
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Zip | 31313
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Country | US
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Telephone | 912-876-6868
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Fax | 912-876-6566
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Provider Business Mailing Address
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Address Line | PHILLIP'S PEDIATRICS, PC 455 S MAIN STREET, STE 103
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City | HINESVILLE
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State | GA
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Zip | 31313
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Country | US
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Telephone | 912-876-6868
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Fax | 912-876-6566
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | GAA-NP000025
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License Number State | GA
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