Provider Demographics
NPI:1376272716
Name:ONYIRIUKA, TOBECHUKWU PRINCETON (FNP-C)
Entity Type:Individual
Prefix:
First Name:TOBECHUKWU
Middle Name:PRINCETON
Last Name:ONYIRIUKA
Suffix:
Gender:M
Credentials:FNP-C
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 1253
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-1253
Mailing Address - Country:US
Mailing Address - Phone:980-483-4400
Mailing Address - Fax:
Practice Address - Street 1:626 GRASSWREN WAY
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9143
Practice Address - Country:US
Practice Address - Phone:704-315-0658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020144363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily