Provider Demographics
NPI:1386258739
Name:OPUNI, EMMANUEL NICHOLAS
Entity type:Individual
Prefix:
First Name:EMMANUEL NICHOLAS
Middle Name:
Last Name:OPUNI
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 1:1454 BARNES DR E
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-9001
Mailing Address - Country:US
Mailing Address - Phone:614-806-4461
Mailing Address - Fax:
Practice Address - Street 1:1454 BARNES DR E
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-9001
Practice Address - Country:US
Practice Address - Phone:614-806-4461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.426243163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No163W00000XNursing Service ProvidersRegistered Nurse