Provider Demographics
NPI:1679156806
Name:EKEM, ROSITA NNENNA
Entity Type:Individual
Prefix:
First Name:ROSITA
Middle Name:NNENNA
Last Name:EKEM
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 1:920 MADISON SUITE 531
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38163-3951
Mailing Address - Country:US
Mailing Address - Phone:901-448-5814
Mailing Address - Fax:
Practice Address - Street 1:956 COURT AVENUE COLEMAN BUILDING SUITE D334
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-0001
Practice Address - Country:US
Practice Address - Phone:901-448-5752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program