Provider Demographics
NPI:1467625897
Name:UDEOJI, DIDACUS O (LPN)
Entity Type:Individual
Prefix:
First Name:DIDACUS
Middle Name:O
Last Name:UDEOJI
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6633 W BURLEIGH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1318
Mailing Address - Country:US
Mailing Address - Phone:414-760-9422
Mailing Address - Fax:888-342-1587
Practice Address - Street 1:6633 W BURLEIGH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-1318
Practice Address - Country:US
Practice Address - Phone:414-760-9422
Practice Address - Fax:888-342-1587
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse