Provider Demographics
NPI:1689452807
Name:OKOANINNEJI, VICTORIA OGECHI
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:OGECHI
Last Name:OKOANINNEJI
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 1:3284 CANDLEFIRE DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-5303
Mailing Address - Country:US
Mailing Address - Phone:614-371-2414
Mailing Address - Fax:
Practice Address - Street 1:3284 CANDLEFIRE DR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-5303
Practice Address - Country:US
Practice Address - Phone:614-371-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0034937163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health