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NPI Code Detail

MEDICARE: GRACE WIREDU CNP

MEDICARE: GRACE WIREDU 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 PractitionerAPRN.CNP.020110OH

General Provider Information

NPI Number : 1952846925
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE WIREDU CNP
Provider Business Mailing Address
First Line : 5000 E MAIN ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-2440
Country : US
Telephone Number : 614-235-5555
Fax Number : 614-536-1994
Provider Business Practice Location Address
First Line : 5000 E MAIN ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-2440
Country : US
Telephone Number : 614-235-5555
Fax Number : 614-536-1994
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2016
Last Update Date : 01/08/2024

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