Individual
FIDELIS OSONDU EBEREONWU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
924 W JESSICA LN, PHOENIX, AZ 85041-3978
(480) 332-8764
Mailing address
924 W JESSICA LN, PHOENIX, AZ 85041-3978
(480) 332-8764
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RNP250307
AZ
Other
Enumeration date
11/21/2020
Last updated
11/21/2020
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