Provider Demographics
NPI:1376116707
Name:OBIECHEFU, GLORIA UZOAKU (LPN)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:UZOAKU
Last Name:OBIECHEFU
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82003
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30608-2003
Mailing Address - Country:US
Mailing Address - Phone:678-549-1125
Mailing Address - Fax:
Practice Address - Street 1:202 OAK BLUFF DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30607-1925
Practice Address - Country:US
Practice Address - Phone:678-549-1125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN083509164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse