Individual
EBENEZER BODUDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
11225 N 28TH DR, PHOENIX, AZ 85029-5606
(602) 699-6999
Mailing address
7067 W JACKRABBIT LN, PEORIA, AZ 85383-6018
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
298440
AZ
Other
Enumeration date
08/27/2015
Last updated
10/25/2023
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