Provider Demographics
NPI:1457637605
Name:ONYEBUEKE, MIRIAN EBELE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MIRIAN
Middle Name:EBELE
Last Name:ONYEBUEKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 FRESHWIND AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2100
Mailing Address - Country:US
Mailing Address - Phone:813-269-8842
Mailing Address - Fax:
Practice Address - Street 1:4610 FRESHWIND AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-2100
Practice Address - Country:US
Practice Address - Phone:813-269-8842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9257460363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health