Jennifer Edugwu Agbo
Student in an Organized Health Care Education/Training Program in Rockford, IL. Individual provider (NPI-1).
NPI number1760237796
StatusActive
Last updated in NPPESApr 22, 2024
Details
- NPI
- 1760237796
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Edugwu Agbo
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 22, 2024
- Certification date
- Apr 22, 2024
- Last updated
- Apr 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
8201 E Riverside BlvdRockford, IL 61114-2300
Phone 815-971-7000
Mailing address
7702 N Alpine RdLoves Park, IL 61111-3107
Phone 815-971-7000
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