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General NPI Number Information
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NPI Number | 1891294161
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Entity Type | Individual
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Provider Name | NNEKA OKOH GODWIN
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Gender | Female
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 5900 FOREST HILLS DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4129
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Country | US
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Telephone | 505-822-6000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 42738
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City | TOWSON
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State | MD
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Zip | 21284-2738
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Country | US
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Telephone | 610-925-1032
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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 | AP136385
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 62480
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License Number State | NM
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