Provider Demographics
NPI:1093314528
Name:ELUMA, NGOZI HELEN
Entity Type:Individual
Prefix:
First Name:NGOZI
Middle Name:HELEN
Last Name:ELUMA
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 1:3727 ANDREWS HWY APT 2903
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-6317
Mailing Address - Country:US
Mailing Address - Phone:682-375-8816
Mailing Address - Fax:
Practice Address - Street 1:3727 ANDREWS HWY APT 2903
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-6317
Practice Address - Country:US
Practice Address - Phone:682-375-8816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1014251163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse