Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 258043 | AZ |
NPI | 1033782909 |
---|---|
Provider Name | Dr. Awungcha Sandra Nkemzi |
First Address | Tucson, AZ 85730-1017 |
Second Address | Tucson, AZ 85730-1017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2021 |
Last Update Date | 30/11/2021 |