Provider Demographics
NPI:1174010888
Name:EKE, UCHENNA (NP)
Entity Type:Individual
Prefix:
First Name:UCHENNA
Middle Name:
Last Name:EKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 N KRAEMER BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-5042
Mailing Address - Country:US
Mailing Address - Phone:714-577-2271
Mailing Address - Fax:
Practice Address - Street 1:151 N KRAEMER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870
Practice Address - Country:US
Practice Address - Phone:714-577-2271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008715363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology