Provider Demographics
NPI:1912764739
Name:KOMETA, UFEI ANWIFOR (NP)
Entity Type:Individual
Prefix:MRS
First Name:UFEI
Middle Name:ANWIFOR
Last Name:KOMETA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8309 REGALIA CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838-5116
Mailing Address - Country:US
Mailing Address - Phone:419-508-6647
Mailing Address - Fax:
Practice Address - Street 1:2420 PEMBERTON RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-2003
Practice Address - Country:US
Practice Address - Phone:888-811-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily