Provider Demographics
NPI:1215519137
Name:UDEH, ANGELA EJINWAEMONU (RN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:EJINWAEMONU
Last Name:UDEH
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 CHASE OAKS BLVD APT 325
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5910
Mailing Address - Country:US
Mailing Address - Phone:214-535-8128
Mailing Address - Fax:
Practice Address - Street 1:2415 E CAMELBACK RD STE 700
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4245
Practice Address - Country:US
Practice Address - Phone:888-279-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1153897363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health