Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP133632 | TX |
N | 363LA2100X | Nurse Practitioner - Acute Care | COA.13362-NP | OH |
NPI | 1033473129 |
---|---|
Provider Name | Amaka Opute |
First Address | Dallas, TX 75284-7208 |
Second Address | Dallas, TX 75390 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2012 |
Last Update Date | 26/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0072176 | (05) | OH |