Individual
OGHENERO EWOMA OLORI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3411 N 16TH ST, PHOENIX, AZ 85016-7150
(602) 576-2873
Mailing address
3411 N 16TH ST APT 1075, PHOENIX, AZ 85016-7167
(602) 576-2873
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
301033
AZ
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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