Individual
IZIEGBE GARUBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1800 COFFEE RD, MODESTO, CA 95355-2705
(209) 572-7262
Mailing address
83 BIRCHFIELD CT, DALLAS, GA 30132-0844
(334) 354-3388
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95006660
CA
363L00000X
Nurse Practitioner
RN221346
GA
Other
Enumeration date
05/29/2017
Last updated
05/29/2017
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