Provider Demographics
NPI:1740551290
Name:GODSPOWER-ODIONG, RUSH (LPN)
Entity type:Individual
Prefix:MR
First Name:RUSH
Middle Name:
Last Name:GODSPOWER-ODIONG
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 HALLE DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-1023
Mailing Address - Country:US
Mailing Address - Phone:216-526-6024
Mailing Address - Fax:
Practice Address - Street 1:329 HALLE DR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-1023
Practice Address - Country:US
Practice Address - Phone:216-526-6024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-14
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH159276164W00000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse