Individual
MR. BETHEL UBOCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2420 SYCAMORE DR APT 58, GREEN BAY, WI 54311-5166
(920) 931-5061
Mailing address
121 WOODROSE CT, ROSEBURG, OR 97471-1646
(920) 931-5061
(541) 440-1394
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
173722-30
WI
363L00000X
Nurse Practitioner
Primary
202001123
OR
363LG0600X
Gerontology Nurse Practitioner
113028-23
NH
Other
Enumeration date
04/09/2014
Last updated
01/09/2025
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