Provider Demographics
NPI:1497258727
Name:OBIORA, NKEMDIRIM (NP-C)
Entity Type:Individual
Prefix:
First Name:NKEMDIRIM
Middle Name:
Last Name:OBIORA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14973 W BELL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-3878
Mailing Address - Country:US
Mailing Address - Phone:623-815-2900
Mailing Address - Fax:623-583-1319
Practice Address - Street 1:14973 W BELL RD STE 100
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3878
Practice Address - Country:US
Practice Address - Phone:623-934-1245
Practice Address - Fax:623-934-3598
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11049363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily