Provider Demographics
NPI:1417129214
Name:UDEANI, PHILOMENA ONYEJELUBECHI (RN, C, BSN)
Entity Type:Individual
Prefix:MRS
First Name:PHILOMENA
Middle Name:ONYEJELUBECHI
Last Name:UDEANI
Suffix:
Gender:F
Credentials:RN, C, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8778 LINICK DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-4782
Mailing Address - Country:US
Mailing Address - Phone:614-864-1035
Mailing Address - Fax:614-864-1035
Practice Address - Street 1:8778 LINICK DR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-4782
Practice Address - Country:US
Practice Address - Phone:614-864-1035
Practice Address - Fax:614-864-1035
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN193416163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse