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General NPI Number Information
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NPI Number | 1952087983
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Entity Type | Individual
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Provider Name | ADENIKE ANDITO NKENGE DURRANT-CAMPBELL
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Gender | Female
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 3712 W NORTHERN AVE APT 444
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City | PHOENIX
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State | AZ
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Zip | 85051-9411
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Country | US
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Telephone | 404-717-7521
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 39196
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City | PHOENIX
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State | AZ
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Zip | 85069-9196
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Country | US
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Telephone | 404-717-7521
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 248699
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License Number State | AZ
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