Provider Demographics
NPI:1104392216
Name:ALIGBE, JEMINATU
Entity Type:Individual
Prefix:
First Name:JEMINATU
Middle Name:
Last Name:ALIGBE
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 1:19400 W BELLFORT ST APT 2314
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-8209
Mailing Address - Country:US
Mailing Address - Phone:240-593-3866
Mailing Address - Fax:
Practice Address - Street 1:19400 W BELLFORT ST APT 2314
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-8209
Practice Address - Country:US
Practice Address - Phone:240-593-3866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX307313164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse