Healthcare Provider Details

I. General information

NPI: 1649364407
Provider Name (Legal Business Name): NNENNA J UWAZIE PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10305 PROMENADE PKWY
ELK GROVE CA
95757-9400
US

IV. Provider business mailing address

8551 CASTLELYONS CT
ELK GROVE CA
95624-3724
US

V. Phone/Fax

Practice location:
  • Phone: 916-544-6044
  • Fax: 916-544-6055
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number048656
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: