Individual
AMANDA AZUBIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4593 MT LAUREL DR, GRAND PRAIRIE, TX 75052
(972) 480-1509
Mailing address
4593 MT LAUREL DR, GRAND PRAIRIE, TX 75052
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
349146
TX
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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