Provider Demographics
NPI:1871315564
Name:OGBONNA, NKEIRUKA ANN (DNP, CNP, FNP)
Entity type:Individual
Prefix:
First Name:NKEIRUKA
Middle Name:ANN
Last Name:OGBONNA
Suffix:
Gender:F
Credentials:DNP, CNP, FNP
Other - Prefix:
Other - First Name:NKEIRUKA
Other - Middle Name:ANN
Other - Last Name:UGWU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2515 16TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56304-8555
Mailing Address - Country:US
Mailing Address - Phone:320-224-8617
Mailing Address - Fax:
Practice Address - Street 1:1301 33RD ST S
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-9604
Practice Address - Country:US
Practice Address - Phone:320-251-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12228363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily