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1669995494 NPI number — MRS. NGOZI EDITH EBOKA

NPI Number: 1669995494
Health Care Provider/Practitioner: MRS. NGOZI EDITH EBOKA

Information about “1669995494” NPI (MRS. NGOZI EDITH EBOKA) exists in 1669995494 in HTML format HTML  |  1669995494 in plain Text format TXT  |  1669995494 in PDF (Portable Document Format) PDF  |  1669995494 in an XML format XML  formats.

NPI Number : 1669995494 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669995494",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "EBOKA",
    "FirstName": "NGOZI",
    "MiddleName": "EDITH",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "OKOLO",
    "OtherFirstName": "NGOZICHUKWUKA",
    "OtherMiddleName": "EDITH",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "NP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "29833 TWIN LAKES RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MENIFEE",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92585-9255",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "909-205-1663",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "29833 TWIN LAKES RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MENIFEE",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92585-9255",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "909-205-1663",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/24/2017",
    "LastUpdateDate": "12/16/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "95006789",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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