NPI 1013636612

Charles Idemudia

Practitioner Licensed Practical Nurse Surprise, AZ

Practice location

Address: 16088 W Soft Wind Dr, Surprise, AZ 85387-1668
Phone: (602) 327-6605

Registered specialties

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence LP039775 (AZ)

Other Licensed Practical Nurse providers in Arizona →

Registry record

NPI: 1013636612
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Aug 2022
Record last updated: 25 Aug 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.