Individual provider · Type 1 NPI
Grace Ebenuwa
Obstetrics & Gynecology Nurse Practitioner · Los Angeles, CA
NPI number
1164629697
Active
Practice location
12021 Wilmington Ave
Los Angeles, CA 90059-3019
Fax (310) 763-8909
Mailing address
1731 Stearns Dr
Los Angeles, CA 90035-4627
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner Primary | 363LX0001X | RN401793 (CA) |
Obstetrics & Gynecology Nurse Practitioner: Definition to come...
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About NPI 1164629697
Grace Ebenuwa's National Provider Identifier is 1164629697, issued on Jun 28, 2007. The primary taxonomy on file is Obstetrics & Gynecology Nurse Practitioner (363LX0001X), and the practice location is in Los Angeles, CA. The record was last updated on Jul 8, 2007.