MEDICARE: NGOZI C AKABUAKU

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	164W00000X	Licensed Practical Nurse	PN.110267-IV	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700013257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGOZI C AKABUAKU

Provider Business Mailing Address
First Line	:	234 PLAYERS CLUB CT
Second Line	:
City	:	COMMERCIAL POINT
State	:	OH
Zip	:	43116-9700
Country	:	US
Telephone Number	:	614-446-0102
Fax Number	:	614-860-0106

Provider Business Practice Location Address
First Line	:	234 PLAYERS CLUB CT
Second Line	:
City	:	COMMERCIAL POINT
State	:	OH
Zip	:	43116-9700
Country	:	US
Telephone Number	:	614-446-0102
Fax Number	:

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

Provider Enumeration Date	:	06/11/2009
Last Update Date	:	03/17/2018

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