Individual
AKANINYENE ETUKUDOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
1095 E INDIAN SCHOOL RD, PHOENIX, AZ 85014-4801
(623) 439-7645
Mailing address
1095 E INDIAN SCHOOL RD STE 700, PHOENIX, AZ 85014-4846
(602) 515-9893
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
267251
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
267251
AZ
Other
Enumeration date
01/05/2022
Last updated
07/29/2022
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