Provider Demographics
NPI:1285367367
Name:NNAJI, ELISHA UKONNA
Entity type:Individual
Prefix:MR
First Name:ELISHA
Middle Name:UKONNA
Last Name:NNAJI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11444 BLOOMFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2778
Mailing Address - Country:US
Mailing Address - Phone:704-222-1253
Mailing Address - Fax:704-849-5251
Practice Address - Street 1:507 WOODSIDE DR
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-2808
Practice Address - Country:US
Practice Address - Phone:704-750-6100
Practice Address - Fax:704-750-6103
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC6635374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide