Provider Demographics
NPI:1174416531
Name:OBI-OSUALA, GENEVIEVE G
Entity type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:G
Last Name:OBI-OSUALA
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 1:335 SLEEPY LN
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-6764
Mailing Address - Country:US
Mailing Address - Phone:478-955-1144
Mailing Address - Fax:478-955-1144
Practice Address - Street 1:335 SLEEPY LN
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-6764
Practice Address - Country:US
Practice Address - Phone:478-955-1144
Practice Address - Fax:478-955-1144
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN324050163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty