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NPI Code Detail

MEDICARE: RITA O ENUNWA RN, NP

MEDICARE:   RITA O ENUNWA  RN, 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
1363L00000XNurse PractitionerNP14955CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497838924
Entity Type Code : Individual
Provider Name (Legal Business Name) : RITA O ENUNWA RN, NP
Provider Business Mailing Address
First Line : 4705 N SONORA AVE STE 113
Second Line :
City : FRESNO
State : CA
Zip : 93722-3965
Country : US
Telephone Number : 559-276-7558
Fax Number : 559-276-7568
Provider Business Practice Location Address
First Line : 4705 N SONORA AVE STE 113
Second Line :
City : FRESNO
State : CA
Zip : 93722-3965
Country : US
Telephone Number : 559-276-7558
Fax Number : 559-276-7568
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 01/22/2019

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