Provider Demographics
NPI:1154644805
Name:CHIMAFOR, LOVELINE NDIKUM
Entity Type:Individual
Prefix:MRS
First Name:LOVELINE
Middle Name:NDIKUM
Last Name:CHIMAFOR
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 1:7556 W SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-2709
Mailing Address - Country:US
Mailing Address - Phone:404-583-5380
Mailing Address - Fax:
Practice Address - Street 1:7556 W SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-2709
Practice Address - Country:US
Practice Address - Phone:404-583-5380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI311893-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse