Josehine Imediegwu Eziolisa

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

125708 Issued in OH

Practice address

7967 Mount Hood
Huber Heights, OH 45424-6931

Phone

(937) 241-2924

NPI assigned

Oct 17, 2007

Last updated

Oct 17, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1851580666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7967 MOUNT HOOD",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454246931",
            "telephone_number": "937-241-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7967 MOUNT HOOD",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454246931",
            "telephone_number": "937-241-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZIOLISA",
        "first_name": "JOSEHINE",
        "middle_name": "IMEDIEGWU",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "125708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Lynn Evans
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• Susanna Everhart, APRN, CNP
• Exceptional Quality Home Care LLC (Exceptional Quality Home Care)
• Extra Hands Care Home Healthcare LLC
• Jessica Fairchild, RBT
• Daryl Fajardo
• Family Physicians of Huber Heights (Shafik Ahmad, MD)
• Family Physicians of Huber Heights
• Far Oaks Orthopedists, Inc

• Licensed Practical Nurse in Huber Heights, OH
• Providers in Huber Heights, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.