Provider Demographics
NPI:1225726102
Name:NWOKOCHA, JULIANA (RN,BSN)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:NWOKOCHA
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11021 FAIR MEADOWS CT
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-1267
Mailing Address - Country:US
Mailing Address - Phone:763-772-3696
Mailing Address - Fax:
Practice Address - Street 1:11021 FAIR MEADOWS CT
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-1267
Practice Address - Country:US
Practice Address - Phone:763-772-3696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based