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Individual

KINGSLEY EBORU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
13555 W MCDOWELL RD STE 205, GOODYEAR, AZ 85395-2626
(623) 295-1190
Mailing address
5501 N 19TH AVE STE 425, PHOENIX, AZ 85015-2481

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
301080
AZ

Other

Enumeration date
12/11/2023
Last updated
12/11/2023
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