MEDICARE: MRS. JUSTINA AMAKA ARIZE NP

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
1	363LP2300X	Primary Care Nurse Practitioner	AP144347	TX

General Provider Information

NPI Number	:	1295348829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JUSTINA AMAKA ARIZE NP

Provider Business Mailing Address
First Line	:	2113 RIVER CANYON LN
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75041-2179
Country	:	US
Telephone Number	:	214-735-5292
Fax Number	:

Provider Business Practice Location Address
First Line	:	2113 RIVER CANYON LN
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75041-2179
Country	:	US
Telephone Number	:	214-735-5292
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2020
Last Update Date	:	08/24/2020

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