Wabomnor, Grace Nwaka

Wabomnor, Grace Nwaka is an individual health care provider with primary practice located at 17 E Grandview Dr , South Holland IL 60473-1099. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Wabomnor, Grace Nwaka can be contacted via phone (708) 439-5003.

Contact Information

Primary practice address
17 E Grandview Dr South Holland IL 60473-1099
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 209018727 Illinois

Profile Details

NPI number 1548725799
LBN Legal business name Wabomnor, Grace Nwaka
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2019
Last updated Feb 1st, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548725799 NPPES
Illinois Other 209018727 ILLINOIS DEPT OF FINANCIAL AND PROFESSIONAL REGULATION

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