Provider Demographics
NPI:1356104764
Name:FOWAD ADVANCED NURSING CARE INC
Entity type:Organization
Organization Name:FOWAD ADVANCED NURSING CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OGHOGHO
Authorized Official - Middle Name:
Authorized Official - Last Name:UHUNMWANGHO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:831-208-4416
Mailing Address - Street 1:3097 WILLOW AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-4715
Mailing Address - Country:US
Mailing Address - Phone:831-208-4416
Mailing Address - Fax:
Practice Address - Street 1:3097 WILLOW AVE STE 10
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-4715
Practice Address - Country:US
Practice Address - Phone:831-208-4416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty