Provider Demographics
NPI:1760748263
Name:UZOMBA, CATHERINE C
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:C
Last Name:UZOMBA
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 1:1464 MILLERDALE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-3145
Mailing Address - Country:US
Mailing Address - Phone:614-365-1921
Mailing Address - Fax:
Practice Address - Street 1:1464 MILLERDALE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-3145
Practice Address - Country:US
Practice Address - Phone:614-365-1921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400424371104376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide