Provider Demographics
NPI:1093169211
Name:OBIEKWE, BEATRICE C (RN)
Entity Type:Individual
Prefix:
First Name:BEATRICE
Middle Name:C
Last Name:OBIEKWE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MARTIN LUTHER KING JR DR SW
Mailing Address - Street 2:SUITE 409
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-1101
Mailing Address - Country:US
Mailing Address - Phone:404-564-6486
Mailing Address - Fax:404-564-6487
Practice Address - Street 1:2001 MARTIN LUTHER KING JR DR SW
Practice Address - Street 2:SUITE 409
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-1101
Practice Address - Country:US
Practice Address - Phone:404-564-6486
Practice Address - Fax:404-564-6487
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN218490163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse