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NPI Code Detail

MEDICARE: GLADYS AMMA ODURO MANU CNP

MEDICARE: GLADYS AMMA ODURO MANU CNP
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
1363LF0000XFamily Nurse PractitionerRX.14854-EX1OH
2363LF0000XFamily Nurse PractitionerRN.317610-COA1OH
3363LF0000XFamily Nurse PractitionerCOA.14854-NPOH

General Provider Information

NPI Number : 1851588602
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLADYS AMMA ODURO MANU CNP
Provider Business Mailing Address
First Line : 1500 E 17TH AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-1002
Country : US
Telephone Number : 614-645-2700
Fax Number : 614-645-2727
Provider Business Practice Location Address
First Line : 1500 E 17TH AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-1002
Country : US
Telephone Number : 614-645-2700
Fax Number : 614-645-2727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2007
Last Update Date : 12/13/2017

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Directions to “ GLADYS AMMA ODURO MANU CNP” Practice Location

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