Provider Demographics
NPI:1952957748
Name:ONUNEKWU, VICTORIA C
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:C
Last Name:ONUNEKWU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:C
Other - Last Name:ONUNEKWU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:2718 KALEY LN NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-2691
Mailing Address - Country:US
Mailing Address - Phone:404-512-9062
Mailing Address - Fax:
Practice Address - Street 1:2718 KALEY LN NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-2691
Practice Address - Country:US
Practice Address - Phone:404-512-9062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN170301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily