Healthcare Provider Details

I. General information

NPI: 1831979913
Provider Name (Legal Business Name): ELIZABETH NKECHI UGWU-UDE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24703 MONROE AVE STE A&B
MURRIETA CA
92562-9569
US

IV. Provider business mailing address

24703 MONROE AVE STE A&B
MURRIETA CA
92562-9569
US

V. Phone/Fax

Practice location:
  • Phone: 951-698-1168
  • Fax:
Mailing address:
  • Phone: 951-698-1168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95027514
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: