Provider Demographics
NPI:1346844461
Name:OGBONNA, NKASIOBI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NKASIOBI
Middle Name:
Last Name:OGBONNA
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:NKASIOBI
Other - Middle Name:
Other - Last Name:IFEADIKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3717 HAMPTON BLVD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-2425
Mailing Address - Country:US
Mailing Address - Phone:404-510-6792
Mailing Address - Fax:
Practice Address - Street 1:3717 HAMPTON BLVD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-2425
Practice Address - Country:US
Practice Address - Phone:404-510-6792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202219389183500000X
GARPH032257183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist