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Individual

MRS. KEYNADOMNICIA CHIOMA UDENZE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGNP-BC

Contact information

Practice address
500 BENSON RD STE 115, GARNER, NC 27529-3947
(984) 246-2006
(984) 246-2005
Mailing address
500 BENSON ROAD, SUITE 115, GARNER, NC 27529-0016
(214) 727-8681
(984) 246-2005

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5009687
NC
363LA2200X
Adult Health Nurse Practitioner
AP131087
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AP131087
NURSE PRACTITIONER LICENSE
TX
Enumeration date
06/20/2016
Last updated
07/13/2021
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