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General NPI Number Information
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NPI Number | 1285367367
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Entity Type | Individual
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Provider Name | MR. ELISHA UKONNA NNAJI
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Gender | Male
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 03/19/2023
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Provider Practice Location Address
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Address Line | 507 WOODSIDE DR
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City | KINGS MOUNTAIN
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State | NC
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Zip | 28086-2808
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Country | US
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Telephone | 704-750-6100
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Fax | 704-750-6103
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Provider Business Mailing Address
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Address Line | 11444 BLOOMFIELD DR
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City | CHARLOTTE
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State | NC
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Zip | 28277-2778
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Country | US
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Telephone | 704-222-1253
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Fax | 704-849-5251
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | HC6635
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License Number State | NC
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