Healthcare Provider Details

I. General information

NPI: 1730925801
Provider Name (Legal Business Name): ARUODO UKPAI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 S LASALLE ST
DURHAM NC
27705-3701
US

IV. Provider business mailing address

616 CROSSTIE ST
KNIGHTDALE NC
27545-9757
US

V. Phone/Fax

Practice location:
  • Phone: 919-383-5521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5020684
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: