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Individual

ANGELA CHUKWUDOLUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2145 W SOUTHERN AVE, MESA, AZ 85202-4715
(480) 835-3000
(480) 512-6257
Mailing address
2510 W DUNLAP AVE, STE 290, PHOENIX, AZ 85021-2759
(602) 789-0344
(602) 789-8389

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
AP1136
AZ
363LG0600X
Gerontology Nurse Practitioner
Primary
AP1137
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
536914
AZ
01
Z128358
MEDICARE PTAN
AZ
Enumeration date
03/27/2006
Last updated
02/17/2020
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