Provider Demographics
NPI:1689458457
Name:UDOKPORO, AMARA (MHA)
Entity Type:Individual
Prefix:MS
First Name:AMARA
Middle Name:
Last Name:UDOKPORO
Suffix:
Gender:F
Credentials:MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3875 TARTAN TRL
Mailing Address - Street 2:
Mailing Address - City:WHITESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46075-7401
Mailing Address - Country:US
Mailing Address - Phone:817-800-4309
Mailing Address - Fax:
Practice Address - Street 1:3875 TARTAN TRL
Practice Address - Street 2:
Practice Address - City:WHITESTOWN
Practice Address - State:IN
Practice Address - Zip Code:46075-7401
Practice Address - Country:US
Practice Address - Phone:817-800-4309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant