Individual
JENNIFER D. OKIDEGBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C
Contact information
Practice address
9250 W THOMAS RD STE 200, PHOENIX, AZ 85037-3382
(623) 516-8252
(623) 516-8253
Mailing address
5281 N 99TH AVE STE 100, GLENDALE, AZ 85305-2209
(623) 516-8252
(623) 691-8502
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP4483
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
713001
—
AZ
Enumeration date
06/16/2012
Last updated
03/26/2021
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