Provider Demographics
NPI:1659668622
Name:ONYILO, WILLIE C (RN)
Entity Type:Individual
Prefix:MR
First Name:WILLIE
Middle Name:C
Last Name:ONYILO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3126 ESPLANADE CIR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-4221
Mailing Address - Country:US
Mailing Address - Phone:404-349-5630
Mailing Address - Fax:
Practice Address - Street 1:3126 ESPLANADE CIR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-4221
Practice Address - Country:US
Practice Address - Phone:404-349-5630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN135600163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent