Provider Demographics
NPI:1407178817
Name:OTI, NKIRU EUNICE
Entity Type:Individual
Prefix:
First Name:NKIRU
Middle Name:EUNICE
Last Name:OTI
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 1:1506 BARNES DR E
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-9006
Mailing Address - Country:US
Mailing Address - Phone:614-854-0824
Mailing Address - Fax:
Practice Address - Street 1:1506 BARNES DR E
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-9006
Practice Address - Country:US
Practice Address - Phone:614-854-0824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 118357164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse