Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP131660 | TX |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 95012185 | CA |
NPI | 1033654397 |
---|---|
Provider Name | Mrs. Angela Adanze Umeorah |
First Address | Fresno, CA 93704-2515 |
Second Address | Coalinga, CA 93210-1704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2016 |
Last Update Date | 04/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0466 | (05) | TX |