MEDICARE: MS. NGOZIKA NANCY EZE 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	163W00000X	Registered Nurse	RN00170958	WA

General Provider Information

NPI Number	:	1629468251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NGOZIKA NANCY EZE RN

Provider Business Mailing Address
First Line	:	PO BOX 50533
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98015-0533
Country	:	US
Telephone Number	:	206-617-0396
Fax Number	:

Provider Business Practice Location Address
First Line	:	1004 107TH AVE SE
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-6845
Country	:	US
Telephone Number	:	206-617-0396
Fax Number	:

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

Provider Enumeration Date	:	02/03/2015
Last Update Date	:	02/03/2015

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