Provider Demographics
NPI:1679897482
Name:EFETEVBIA-ELIKWU, DEBBY ONORIODE
Entity Type:Individual
Prefix:MRS
First Name:DEBBY
Middle Name:ONORIODE
Last Name:EFETEVBIA-ELIKWU
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 1:4630 TAMARACK BLVD
Mailing Address - Street 2:APT C-8
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229
Mailing Address - Country:US
Mailing Address - Phone:614-475-4385
Mailing Address - Fax:
Practice Address - Street 1:4630 TAMARACK BLVD
Practice Address - Street 2:APT C-8
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229
Practice Address - Country:US
Practice Address - Phone:614-475-4385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN138309-N-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse