Provider Demographics
NPI:1508572256
Name:NGUEUDJIO, ANTOINNETTE B
Entity Type:Individual
Prefix:MRS
First Name:ANTOINNETTE
Middle Name:B
Last Name:NGUEUDJIO
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 1:3045 AMBARWENT RD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-7064
Mailing Address - Country:US
Mailing Address - Phone:614-795-3578
Mailing Address - Fax:
Practice Address - Street 1:3045 AMBARWENT RD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-7064
Practice Address - Country:US
Practice Address - Phone:614-795-3578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH502661163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse