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General NPI Number Information
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NPI Number | 1871756973
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Entity Type | Individual
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Provider Name | CHARLES CHUKWUDI IKE LPN
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Gender | Male
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 1291 PADDINGTON CT
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City | GAHANNA
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State | OH
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Zip | 43230-1736
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Country | US
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Telephone | 614-843-1343
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Fax |
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Provider Business Mailing Address
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Address Line | 1291 PADDINGTON CT
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City | GAHANNA
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State | OH
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Zip | 43230-1736
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Country | US
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Telephone | 614-843-1343
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN117579-MEDS
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN11579-MEDS
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License Number State | OH
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