Provider Demographics
NPI:1679887830
Name:DURU, GRACE IHEOMA
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:IHEOMA
Last Name:DURU
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 1:3277 KADY LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-7455
Mailing Address - Country:US
Mailing Address - Phone:614-623-5270
Mailing Address - Fax:
Practice Address - Street 1:3277 KADY LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-7455
Practice Address - Country:US
Practice Address - Phone:614-623-5270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH362516163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse