Provider Demographics
NPI:1235347204
Name:OPUROKU, CATHERINE ALABA (LPN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ALABA
Last Name:OPUROKU
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 E WAGONER RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-8829
Mailing Address - Country:US
Mailing Address - Phone:602-882-8203
Mailing Address - Fax:602-787-4235
Practice Address - Street 1:2825 E WAGONER RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-8829
Practice Address - Country:US
Practice Address - Phone:602-882-8203
Practice Address - Fax:602-787-4235
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPO37173164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse