Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 8842 | MN |
NPI | 1023777570 |
---|---|
Provider Name | Ogechukwu Ugwu |
First Address | Oakdale, MN 55128-7127 |
Second Address | Oakdale, MN 55128-7127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2021 |
Last Update Date | 13/12/2021 |