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Individual
CHIOMA STELLA GOODLUCK
Active
Individual
CHIOMA STELLA GOODLUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
737620-01
NY
363L00000X
Nurse Practitioner
F353448-01
NY
363LF0000X
Family Nurse Practitioner
F353448-01
NY
Other
Enumeration date
12/07/2023
Last updated
07/30/2024
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