Provider Demographics
NPI:1265293617
Name:WULAH, NAOMI (RN)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:WULAH
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 1:7124 FLORIN PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828-2617
Mailing Address - Country:US
Mailing Address - Phone:916-509-0437
Mailing Address - Fax:
Practice Address - Street 1:7124 FLORIN PERKINS RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95828-2617
Practice Address - Country:US
Practice Address - Phone:916-509-0437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ239101163W00000X
CA95354904163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse