Individual
FAYE IWUEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
604 W 8TH AVE APT 255, MESA, AZ 85210-3581
(314) 755-9158
Mailing address
604 W 8TH AVE APT 255, MESA, AZ 85210-3581
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2013016438
MO
Other
Enumeration date
08/24/2016
Last updated
08/24/2016
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