MEDICARE: MRS. VERONICA I OHWOWHIAGBESE APRN

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	163WG0000X	General Practice Registered Nurse	255847	GA

General Provider Information

NPI Number	:	1922850528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VERONICA I OHWOWHIAGBESE APRN

Provider Business Mailing Address
First Line	:	680 OLD JOHNSON RD
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-6251
Country	:	US
Telephone Number	:	770-335-1202
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 OLD JOHNSON RD
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-6251
Country	:	US
Telephone Number	:	770-335-1202
Fax Number	:

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

Provider Enumeration Date	:	04/05/2024
Last Update Date	:	04/05/2024

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