Provider Demographics
NPI:1710276746
Name:NWABUOBI, ANN EGO (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ANN
Middle Name:EGO
Last Name:NWABUOBI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2432 UNIVERSITY AVE
Mailing Address - Street 2:APT.1E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-5605
Mailing Address - Country:US
Mailing Address - Phone:917-753-0188
Mailing Address - Fax:
Practice Address - Street 1:2432 UNIVERSITY AVE
Practice Address - Street 2:APT.1E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-5605
Practice Address - Country:US
Practice Address - Phone:917-753-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304742-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse