Individual
BERNADETTE UDEOZOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
576 JEFFERSON AVE, FORT EUSTIS, VA 23604-1373
(757) 314-7500
Mailing address
12 CEDARWOOD WAY APT A, NEWPORT NEWS, VA 23608-4516
(917) 402-0007
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
F3429171
NY
363LF0000X
Family Nurse Practitioner
Primary
342917
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11111111
ED
NY
05
—
NA
—
NY
Enumeration date
05/22/2018
Last updated
11/17/2022
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