Provider Demographics
NPI:1649003815
Name:OBASI, NMAJU AZU
Entity type:Individual
Prefix:
First Name:NMAJU
Middle Name:AZU
Last Name:OBASI
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 1:521 BROOKSIDE FOREST CT
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-5089
Mailing Address - Country:US
Mailing Address - Phone:314-327-2033
Mailing Address - Fax:
Practice Address - Street 1:2 PROGRESS POINT PKWY
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-2205
Practice Address - Country:US
Practice Address - Phone:636-344-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019024149163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse