MEDICARE: NONYE NDUKA

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	376G00000X	Nursing Home Administrator	AL12373	FL

General Provider Information

NPI Number	:	1821415969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NONYE NDUKA

Provider Business Mailing Address
First Line	:	7655 COLLINS RIDGE BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-6422
Country	:	US
Telephone Number	:	904-379-3746
Fax Number	:	904-379-5743

Provider Business Practice Location Address
First Line	:	7655 COLLINS RIDGE BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-6422
Country	:	US
Telephone Number	:	904-379-3746
Fax Number	:	904-379-5743

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

Provider Enumeration Date	:	03/26/2014
Last Update Date	:	03/26/2014

Similar Medicare Providers

1164854212 — HOME FOR ME
Practice Location Address:

7655 COLLINS RIDGE BLVD
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1801749031 — JESSICA DANIELA BALLEN JIMENEZ
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1760335582 — A FULLER LIFESTYLE GROUP HOME INC
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1033965231 — KERMIDE LAGUERRE
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Directions to “ NONYE NDUKA ” Practice Location

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