Provider Demographics
NPI:1487228524
Name:ODENIGBO, NKOLIKA JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NKOLIKA
Middle Name:JEAN
Last Name:ODENIGBO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NKOLIKA
Other - Middle Name:JEAN
Other - Last Name:NDINECHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1647 NICHOLAS LN UNIT 3
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-4179
Mailing Address - Country:US
Mailing Address - Phone:862-888-4137
Mailing Address - Fax:
Practice Address - Street 1:1545 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-1122
Practice Address - Country:US
Practice Address - Phone:718-613-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program