Provider Demographics
NPI:1043774102
Name:UZOMBA, RITA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:
Last Name:UZOMBA
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 S BAGDAD RD
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-2818
Mailing Address - Country:US
Mailing Address - Phone:512-528-5111
Mailing Address - Fax:512-456-0994
Practice Address - Street 1:2200 S BAGDAD RD
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-2818
Practice Address - Country:US
Practice Address - Phone:512-528-5111
Practice Address - Fax:512-456-0994
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107248163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse