Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Primary Care |
261QP2300X |
| NPI Number | 1235801366 |
| LBN Legal business name | ADVANCE FAMILY CLINIC LLC |
| Authorized official | EZINNE CHUKWUOCHA - (FNP) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/28/2021 |
| Last updated | 12/23/2021 - About 4 years ago |
| Identifiers | n/a |
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