MEDICARE: JULIANA MANYOH ENOAKPA DNP, ARNP, FNP-C

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	363L00000X	Nurse Practitioner	A136210	IA

General Provider Information

NPI Number	:	1427532803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANA MANYOH ENOAKPA DNP, ARNP, FNP-C

Provider Business Mailing Address
First Line	:	3412 GROVE PL
Second Line	:
City	:	BETTENDORF
State	:	IA
Zip	:	52722-6904
Country	:	US
Telephone Number	:	319-693-1780
Fax Number	:

Provider Business Practice Location Address
First Line	:	1351 W CENTRAL PARK AVE STE 3300
Second Line	:
City	:	DAVENPORT
State	:	IA
Zip	:	52804-1889
Country	:	US
Telephone Number	:	563-421-0430
Fax Number	:	563-421-0439

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

Provider Enumeration Date	:	09/20/2018
Last Update Date	:	10/12/2018

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