Provider Demographics
NPI:1396104659
Name:ADEWUMI, UGOCHI NNEKA (NP)
Entity type:Individual
Prefix:MRS
First Name:UGOCHI
Middle Name:NNEKA
Last Name:ADEWUMI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 CAMPBELL HILL ST NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1144
Mailing Address - Country:US
Mailing Address - Phone:770-919-0025
Mailing Address - Fax:
Practice Address - Street 1:805 CAMPBELL HILL ST NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1144
Practice Address - Country:US
Practice Address - Phone:770-919-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN222309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily