Provider Demographics
NPI:1679199061
Name:MBAH, ONORINE ABOH (RN)
Entity Type:Individual
Prefix:
First Name:ONORINE
Middle Name:ABOH
Last Name:MBAH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6422 SEAFORD RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-7911
Mailing Address - Country:US
Mailing Address - Phone:325-513-1949
Mailing Address - Fax:
Practice Address - Street 1:6422 SEAFORD RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-7911
Practice Address - Country:US
Practice Address - Phone:325-513-1949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX966423163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse