Provider Demographics
NPI:1033833819
Name:NWAGBO, BLESSING NTACHIOBI
Entity Type:Individual
Prefix:
First Name:BLESSING
Middle Name:NTACHIOBI
Last Name:NWAGBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4229 MUSTARD CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-9137
Mailing Address - Country:US
Mailing Address - Phone:949-501-8553
Mailing Address - Fax:
Practice Address - Street 1:4229 MUSTARD CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93314-9137
Practice Address - Country:US
Practice Address - Phone:949-501-8553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95085619163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse