Individual
VANESSA IFUNANYA UDOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
427 BLUE RIDGE DR APT G104, AUGUSTA, GA 30907-2772
(706) 559-8641
Mailing address
427 BLUE RIDGE DR APT G104, AUGUSTA, GA 30907-2772
(706) 559-8641
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN209604
GA
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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