Provider Demographics
NPI:1649934886
Name:OBI, LILIAN CHICHEBE
Entity type:Individual
Prefix:
First Name:LILIAN
Middle Name:CHICHEBE
Last Name:OBI
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 1:1037 SHEYENNE PARK PL
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-3229
Mailing Address - Country:US
Mailing Address - Phone:407-782-4301
Mailing Address - Fax:
Practice Address - Street 1:1037 SHEYENNE PARK PL
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3229
Practice Address - Country:US
Practice Address - Phone:407-782-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR42492163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult