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General NPI Number Information
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NPI Number | 1467406868
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Entity Type | Individual
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Provider Name | UGOEZI BRIDGET AGU
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Gender | Female
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 500 N RAINBOW BLVD STE 300
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City | LAS VEGAS
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State | NV
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Zip | 89107-1061
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Country | US
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Telephone | 702-508-6608
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Fax | 702-508-6643
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Provider Business Mailing Address
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Address Line | 500 N RAINBOW BLVD STE 300
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City | LAS VEGAS
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State | NV
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Zip | 89107-1061
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Country | US
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Telephone | 702-508-6608
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Fax | 702-508-6643
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN33247
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN000871
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN000871
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License Number State | NV
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