Provider Demographics
NPI:1699101659
Name:UKPAKA, NNABUGO DARLINGTON (PHARM D)
Entity type:Individual
Prefix:
First Name:NNABUGO
Middle Name:DARLINGTON
Last Name:UKPAKA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 HUNTER XING
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-8133
Mailing Address - Country:US
Mailing Address - Phone:609-505-3534
Mailing Address - Fax:
Practice Address - Street 1:712 HUNTER XING
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-8133
Practice Address - Country:US
Practice Address - Phone:609-505-3534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019975183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist