Provider Demographics
NPI:1568604445
Name:UDOINWANG, MUINAT ADEPEJU (RN)
Entity Type:Individual
Prefix:
First Name:MUINAT
Middle Name:ADEPEJU
Last Name:UDOINWANG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2432 W PEORIA AVE
Mailing Address - Street 2:BUILDING 5 SUITE 1120
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4726
Mailing Address - Country:US
Mailing Address - Phone:602-246-1115
Mailing Address - Fax:602-246-1114
Practice Address - Street 1:2432 W PEORIA AVE
Practice Address - Street 2:BUILDING 5 SUITE 1120
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4726
Practice Address - Country:US
Practice Address - Phone:602-246-1115
Practice Address - Fax:602-246-1114
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA3362251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health