Individual
FERDINAND EKWUTOSI ENUDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
100 LAKE TRAVERSE DR, SISSETON, SD 57262-7046
(605) 698-7606
(651) 431-7462
Mailing address
512 OLD AGENCY DR UNIT 138, SISSETON, SD 57262-7227
(713) 478-5660
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
137180
TX
Other
Enumeration date
05/02/2018
Last updated
09/20/2018
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