Provider Demographics
NPI:1538442538
Name:IWUAFOR, ROSE U (LPN)
Entity type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:U
Last Name:IWUAFOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2924 HAU DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3280
Mailing Address - Country:US
Mailing Address - Phone:614-592-5875
Mailing Address - Fax:
Practice Address - Street 1:6121 ZACHARY WOODS LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-6487
Practice Address - Country:US
Practice Address - Phone:614-592-5875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH125307164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse