Ngulefac Richard Achaleke, RN

Individual provider Active NPI Registered Nurse · Lawrenceville, GA

NPI 1295299386 · NPPES record last updated Jan 23, 2019

Key facts

NPI
1295299386
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
169417 (AZ)
Practice address
175 Gwinnett Dr
Lawrenceville, GA 30046-8444
Phone
(678) 209-2411
NPI assigned
Jan 23, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
169417AZMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Cherish Group Home LLC Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 169417 AZ Yes

Addresses

Primary practice location

175 Gwinnett Dr
Lawrenceville, GA 30046-8444

Mailing address

838 Overlook Path LN
Lawrenceville, GA 30045-8804

Other providers in Lawrenceville, GA

All providers in Lawrenceville, GA · Registered Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.