Provider Demographics
NPI:1750587135
Name:WOKUKWU, MONICA HARVEY (OTR)
Entity type:Individual
Prefix:MR
First Name:MONICA
Middle Name:HARVEY
Last Name:WOKUKWU
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 STILLMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2601
Mailing Address - Country:US
Mailing Address - Phone:205-366-9600
Mailing Address - Fax:
Practice Address - Street 1:1300 MCFARLAND BLVD NE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2252
Practice Address - Country:US
Practice Address - Phone:205-752-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2321174400000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered174400000XOther Service ProvidersSpecialist
Not Answered251E00000XAgenciesHome Health