Provider Demographics
NPI:1467299784
Name:OZONWANKWO, ERNEST C (CNA)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:C
Last Name:OZONWANKWO
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1884 CHIMNEY LN APT 3D
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45440-4116
Mailing Address - Country:US
Mailing Address - Phone:708-916-0844
Mailing Address - Fax:
Practice Address - Street 1:1884 CHIMNEY LN APT 3D
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45440-4116
Practice Address - Country:US
Practice Address - Phone:708-916-0844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide