Theodora Chukwudi, FNP
Nurse Practitioner, Family in Allen Park, MI. Individual provider (NPI-1).
NPI number1063005403
StatusActive
Last updated in NPPESJun 17, 2024
Details
- NPI
- 1063005403
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Theodora Chukwudi
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 17, 2021
- Certification date
- Jun 17, 2024
- Last updated
- Jun 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 4704249499 | MI | Yes |
Practice location
7445 Allen Rd Ste 270Allen Park, MI 48101-1963
Phone 313-920-6546 · Fax 313-949-5793
Mailing address
45300 Cherry Hill RdCanton, MI 48187-5073
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