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General NPI Number Information
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NPI Number | 1902685993
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Entity Type | Individual
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Provider Name | FELICIA UGBORUGBO
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Gender | Female
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Dates
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Enumeration Date | 09/27/2023
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 3448 E AMBER LN
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City | GILBERT
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State | AZ
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Zip | 85296-1839
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Country | US
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Telephone | 480-510-6615
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Fax |
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Provider Business Mailing Address
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Address Line | 5501 N 19TH AVE STE 425
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City | PHOENIX
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State | AZ
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Zip | 85015-2481
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Country | US
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Telephone | 480-510-6615
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 297761
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License Number State | AZ
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