Individual
EZIOMA C ONWUKANJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 HUNTER CREEK DR, YORK, PA 17406-6022
(717) 793-6240
Mailing address
215 HUNTER CREEK DR, YORK, PA 17406-6022
(717) 793-6240
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
SP19612
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP19612
LICENSE NUMBER
PA
Enumeration date
11/16/2018
Last updated
11/16/2018
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