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General NPI Number Information
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NPI Number | 1316415946
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Entity Type | Individual
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Provider Name | MARILENA A ORIEUKWU NP
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Gender | Female
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 06/27/2019
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Provider Practice Location Address
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Address Line | 287 E HUNT HWY STE 105
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143-5096
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Country | US
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Telephone | 480-677-8282
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Fax | 480-535-0962
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Provider Business Mailing Address
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Address Line | PO BOX 23721
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City | PHOENIX
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State | AZ
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Zip | 85063-3721
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Country | US
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Telephone | 602-620-4785
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP11677
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License Number State | AZ
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