Provider Demographics
NPI:1376987792
Name:NNABUIFE, FREDERICK OSUJI JR
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:OSUJI
Last Name:NNABUIFE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 E SERENE AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074
Mailing Address - Country:UM
Mailing Address - Phone:702-917-5299
Mailing Address - Fax:
Practice Address - Street 1:2540 E SERENE AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-6459
Practice Address - Country:US
Practice Address - Phone:702-917-5299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator