MEDICARE: JENNIFER C NDUDI

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	163W00000X	Registered Nurse	943674	TX

General Provider Information

NPI Number	:	1326539479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER C NDUDI

Provider Business Mailing Address
First Line	:	5638 DUCK CREEK DR APT E
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75043-6821
Country	:	US
Telephone Number	:	214-714-4052
Fax Number	:

Provider Business Practice Location Address
First Line	:	5638 DUCK CREEK DR APT E
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75043-6821
Country	:	US
Telephone Number	:	214-714-4052
Fax Number	:

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

Provider Enumeration Date	:	05/24/2018
Last Update Date	:	05/24/2018

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Directions to “ JENNIFER C NDUDI ” Practice Location

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