Provider Demographics
NPI:1477118602
Name:ASIEGBU RN BSN, OBIOMA MARYANN
Entity Type:Individual
Prefix:
First Name:OBIOMA
Middle Name:MARYANN
Last Name:ASIEGBU RN BSN
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 1:3121D FIRE RD # 169
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-9601
Mailing Address - Country:US
Mailing Address - Phone:609-380-2256
Mailing Address - Fax:844-422-7373
Practice Address - Street 1:408 BETHEL RD STE B-4
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2183
Practice Address - Country:US
Practice Address - Phone:609-380-2256
Practice Address - Fax:844-422-7373
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR14951400163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health