Provider Demographics
NPI:1962993923
Name:OBONNA, CHIKAODI BLESSING
Entity type:Individual
Prefix:
First Name:CHIKAODI
Middle Name:BLESSING
Last Name:OBONNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 SHADY GROVE CT
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-8144
Mailing Address - Country:US
Mailing Address - Phone:214-556-7755
Mailing Address - Fax:
Practice Address - Street 1:1608 SHADY GROVE CT
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-8144
Practice Address - Country:US
Practice Address - Phone:214-556-7755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX942917163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse