Provider Demographics
NPI:1770844318
Name:UBANII, IKENNA (LPN200001681)
Entity type:Individual
Prefix:
First Name:IKENNA
Middle Name:
Last Name:UBANII
Suffix:
Gender:M
Credentials:LPN200001681
Other - Prefix:
Other - First Name:IKENNA
Other - Middle Name:
Other - Last Name:UBANII
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN200001681
Mailing Address - Street 1:2600 BRYAN PL SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-4417
Mailing Address - Country:US
Mailing Address - Phone:240-550-6808
Mailing Address - Fax:
Practice Address - Street 1:1818 NEW YORK AV
Practice Address - Street 2:GLOBAL HEALH CARE 117
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002
Practice Address - Country:US
Practice Address - Phone:202-480-0813
Practice Address - Fax:202-503-2363
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN200001681164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse