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General NPI Number Information
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NPI Number | 1932097573
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Entity Type | Individual
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Provider Name | EDITH NDUKWE
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Gender | Female
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 34764 DEQUINDRE RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-5279
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Country | US
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Telephone | 856-493-2980
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Fax |
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Provider Business Mailing Address
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Address Line | 6471 ANNA DR
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City | VAN BUREN TWP
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State | MI
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Zip | 48111-5254
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Country | US
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Telephone | 734-624-4438
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704303329
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License Number State | MI
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