Provider Demographics
NPI:1851517460
Name:NDEFO, NKEMDILIM (CNM)
Entity Type:Individual
Prefix:MS
First Name:NKEMDILIM
Middle Name:
Last Name:NDEFO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7470 N FIGUEROA ST
Mailing Address - Street 2:#104
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1725
Mailing Address - Country:US
Mailing Address - Phone:323-254-7775
Mailing Address - Fax:
Practice Address - Street 1:7470 N FIGUEROA ST
Practice Address - Street 2:#104
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1725
Practice Address - Country:US
Practice Address - Phone:323-254-7775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1460367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife