Individual
NNEMDI O AZUBUKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 825-9660
(617) 288-7898
Mailing address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 825-9660
(617) 288-7898
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2336411
MA
363L00000X
Nurse Practitioner
Primary
RN2336411
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110164464A
—
MA
Enumeration date
04/30/2020
Last updated
11/28/2023
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