Provider Demographics
NPI:1982251971
Name:UGWONALI, UGOCHI A (LVN)
Entity Type:Individual
Prefix:
First Name:UGOCHI
Middle Name:A
Last Name:UGWONALI
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:UGOCHI
Other - Middle Name:ADANNA
Other - Last Name:UGWONALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:316 BLUELEAF DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1515
Mailing Address - Country:US
Mailing Address - Phone:817-729-5758
Mailing Address - Fax:
Practice Address - Street 1:316 BLUELEAF DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1515
Practice Address - Country:US
Practice Address - Phone:817-729-5758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332799164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse