MEDICARE: EFE RITA IJEH RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	RN218475	GA

General Provider Information

NPI Number	:	1578413431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EFE RITA IJEH RN

Provider Business Mailing Address
First Line	:	368 W PIKE ST STE 102
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30046-3240
Country	:	US
Telephone Number	:	678-606-2369
Fax Number	:	770-303-8935

Provider Business Practice Location Address
First Line	:	368 W PIKE ST STE 102
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30046-3240
Country	:	US
Telephone Number	:	678-606-2369
Fax Number	:	770-303-8935

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2026
Last Update Date	:	01/30/2026

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