Provider Demographics
NPI:1043514714
Name:IMA-ABASI, GOODNESS (LPN)
Entity type:Individual
Prefix:MS
First Name:GOODNESS
Middle Name:
Last Name:IMA-ABASI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:EKANEM
Other - Middle Name:
Other - Last Name:ITA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4672 HARBINGER CIR W
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-6115
Mailing Address - Country:US
Mailing Address - Phone:614-339-9478
Mailing Address - Fax:
Practice Address - Street 1:4672 HARBINGER CIR W
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-6115
Practice Address - Country:US
Practice Address - Phone:614-260-9968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH143328164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse