Provider Demographics
NPI:1760245427
Name:CHUKWU, IMMACULATE OJIUGO (RN)
Entity Type:Individual
Prefix:
First Name:IMMACULATE
Middle Name:OJIUGO
Last Name:CHUKWU
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 1:3341 VALERIE ARMS DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-2124
Mailing Address - Country:US
Mailing Address - Phone:937-560-9499
Mailing Address - Fax:
Practice Address - Street 1:3341 VALERIE ARMS DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-2124
Practice Address - Country:US
Practice Address - Phone:937-560-9499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.512323163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty