Provider Demographics
NPI:1053174888
Name:MUNONYE, UJUNWA M
Entity type:Individual
Prefix:
First Name:UJUNWA
Middle Name:M
Last Name:MUNONYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6319 WALLARD DR APT F
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-4441
Mailing Address - Country:US
Mailing Address - Phone:316-200-8869
Mailing Address - Fax:
Practice Address - Street 1:6319 WALLARD DR APT F
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-4441
Practice Address - Country:US
Practice Address - Phone:316-200-8869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INHHA2002119374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide