Provider Demographics
NPI:1407463383
Name:UWASE, AURORA (CERTIFIED NURSE AIDE)
Entity Type:Individual
Prefix:
First Name:AURORA
Middle Name:
Last Name:UWASE
Suffix:
Gender:F
Credentials:CERTIFIED NURSE AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6437 WOOD CIR W
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-1732
Mailing Address - Country:US
Mailing Address - Phone:404-399-0871
Mailing Address - Fax:
Practice Address - Street 1:6437 WOOD CIR W
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-1732
Practice Address - Country:US
Practice Address - Phone:404-399-0871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0014192353374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide