Provider Demographics
NPI:1992009880
Name:WOGU, NWADINMA
Entity Type:Individual
Prefix:
First Name:NWADINMA
Middle Name:
Last Name:WOGU
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 1:550 S DUPONT PKWY
Mailing Address - Street 2:BEAVERBROOKS APT. 20W
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-5193
Mailing Address - Country:US
Mailing Address - Phone:302-345-8212
Mailing Address - Fax:
Practice Address - Street 1:6521 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-2816
Practice Address - Country:US
Practice Address - Phone:267-292-2647
Practice Address - Fax:267-292-2657
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN284832164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse