Provider Demographics
NPI:1487873766
Name:CHUKWUMAH, MANETTE (RN)
Entity type:Individual
Prefix:MRS
First Name:MANETTE
Middle Name:
Last Name:CHUKWUMAH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6383 SHELTON CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1738
Mailing Address - Country:US
Mailing Address - Phone:614-975-4244
Mailing Address - Fax:
Practice Address - Street 1:6383 SHELTON CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1738
Practice Address - Country:US
Practice Address - Phone:614-975-4244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN268337163W00000X, 163WI0500X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
Not Answered163WP0200XNursing Service ProvidersRegistered NursePediatrics