Provider Demographics
NPI:1265911184
Name:ONYEUKWU-REAGAN, SALLIE CELESTINE
Entity type:Individual
Prefix:MS
First Name:SALLIE
Middle Name:CELESTINE
Last Name:ONYEUKWU-REAGAN
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 1:301 G ST SW APT 122
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-3108
Mailing Address - Country:US
Mailing Address - Phone:703-855-7437
Mailing Address - Fax:
Practice Address - Street 1:301 G ST SW APT 122
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-3108
Practice Address - Country:US
Practice Address - Phone:703-855-7437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant