Provider Demographics
NPI:1760232508
Name:EZE MOKA, UCHECHI ONYINYECHI
Entity Type:Individual
Prefix:
First Name:UCHECHI
Middle Name:ONYINYECHI
Last Name:EZE MOKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:UCHECHI
Other - Middle Name:ONYINYECHI
Other - Last Name:EZE MOKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3003 N CENTRAL AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2929
Mailing Address - Country:US
Mailing Address - Phone:602-685-6000
Mailing Address - Fax:602-302-7925
Practice Address - Street 1:8804 N 23RD AVE STE A1A2
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4160
Practice Address - Country:US
Practice Address - Phone:602-216-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ306358363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care