Provider Demographics
NPI:1427532803
Name:ENOAKPA, JULIANA MANYOH (DNP, ARNP, FNP-C)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:MANYOH
Last Name:ENOAKPA
Suffix:
Gender:F
Credentials:DNP, ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 GROVE PL
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-6904
Mailing Address - Country:US
Mailing Address - Phone:319-693-1780
Mailing Address - Fax:
Practice Address - Street 1:1351 W CENTRAL PARK AVE STE 3300
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-1889
Practice Address - Country:US
Practice Address - Phone:563-421-0430
Practice Address - Fax:563-421-0439
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA136210363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner