Provider Demographics
NPI:1457044836
Name:ONA, IFEANULI OBIAGELI (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:IFEANULI
Middle Name:OBIAGELI
Last Name:ONA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 FAIRCHILD AVE
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-1707
Mailing Address - Country:US
Mailing Address - Phone:862-357-5834
Mailing Address - Fax:
Practice Address - Street 1:118 FAIRCHILD AVE
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-1707
Practice Address - Country:US
Practice Address - Phone:201-923-7168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14850100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health