Provider Demographics
NPI:1326465089
Name:ONYEJIAKA, EBERECHI OBI
Entity Type:Individual
Prefix:MRS
First Name:EBERECHI
Middle Name:OBI
Last Name:ONYEJIAKA
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 1:525 GALESBURG CT.
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217
Mailing Address - Country:US
Mailing Address - Phone:615-569-6811
Mailing Address - Fax:615-730-9060
Practice Address - Street 1:525 GALESBURG CT.
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217
Practice Address - Country:US
Practice Address - Phone:615-569-6811
Practice Address - Fax:615-730-9060
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN01604311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home