JENNIFER D. OKIDEGBE


Address: 19636 N 27th Ave Ste 106, Phoenix, AZ 85027-4014
Phone: 6235168252

JENNIFER D. OKIDEGBE (NPI# 1285997163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285997163
Entity Type Individual
Full Name JENNIFER D. OKIDEGBE
Credential FNP
Practice Address 19636 N 27th Ave Ste 106
Phoenix
AZ 85027-4014
Mailing Address 5281 N 99th Ave Ste 100
Glendale
AZ 85305-2209
Practice Telephone 6235168252
Practice Fax Number 6235168253
Mailing Telephone 6235168252
Mailing Fax Number 6236918502
Enumeration Date 2012-06-16
Last Update Date 2017-03-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
AP4483 AZ Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
AZ 713001 05

Office Location

Street Address 19636 N 27TH AVE STE 106
City PHOENIX
State AZ
Zip Code 85027-4014

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NPI Name Taxonomy Address Enumeration
1407479645 Elizabeth Adair Freese Counselor 19636 N 27th Ave Ste 106, Phoenix, AZ 85027-4014 2020-05-22

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1588900021 Jill Elizabeth Maroscia Social Worker 19636 N 27th Ave #106, Phoenix, AZ 85027 2013-01-02
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1396360749 Ulivvo Inc. Nurse Practitioner 141 E Palm Lane, Suite 206, Phoenix, AZ 85004 2020-06-11
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1992326102 Ashley Elizabeth Hall Nurse Practitioner 15810 N 18th St, Phoenix, AZ 85022-3302 2020-04-28
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1295365724 Jessica Veasy Nurse Practitioner 7251 N 23rd Ave, Phoenix, AZ 85021-7714 2020-01-23
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Competitor

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City PHOENIX
Zip Code 85027

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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