Individual provider · Type 1 NPI
Raphael Sopunim Udom
Registered Nurse · Decatur, GA
Practice location
1670 Clairmont Rd
Decatur, GA 30033-4004
Mailing address
3720 Long Lake Dr
Douglasville, GA 30135-7654
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse Primary | 163W00000X | 241170 (GA) |
Registered Nurse: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…
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About NPI 1285467217
Raphael Sopunim Udom's National Provider Identifier is 1285467217, issued on Aug 23, 2024. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Decatur, GA. The record was last updated on Aug 23, 2024.