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NPI Code Detail

MEDICARE: ANIEKAN UDOH APRN, PMHNP- BC

MEDICARE: ANIEKAN UDOH APRN, PMHNP- BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner1172829TX

General Provider Information

NPI Number : 1164903399
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANIEKAN UDOH APRN, PMHNP- BC
Provider Business Mailing Address
First Line : 600 1ST AVE
Second Line : SUITE 102 #2096
City : SEATTLE
State : WA
Zip : 98104-2287
Country : US
Telephone Number : 281-846-5587
Fax Number :
Provider Business Practice Location Address
First Line : 600 1ST AVE
Second Line : SUITE 102 #2096
City : SEATTLE
State : WA
Zip : 98104-2287
Country : US
Telephone Number : 832-433-0465
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2018
Last Update Date : 11/16/2024

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