Provider Demographics
NPI:1871123588
Name:ULUMENFO, BIBIANA CHIDIMMA (PMHNP, BSN, RN)
Entity type:Individual
Prefix:MRS
First Name:BIBIANA
Middle Name:CHIDIMMA
Last Name:ULUMENFO
Suffix:
Gender:F
Credentials:PMHNP, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 BLUE MOUNTAIN LN
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-1785
Mailing Address - Country:US
Mailing Address - Phone:615-586-8701
Mailing Address - Fax:
Practice Address - Street 1:2 INTERNATIONAL PLZ
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2017
Practice Address - Country:US
Practice Address - Phone:615-367-8824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000110445163W00000X
TNAPN0000030932363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse