Basic Information
| Provider Information | |||||||||
| NPI: | 1053825224 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ONYEAKAZI | ||||||||
| FirstName: | STELLA | ||||||||
| MiddleName: | |||||||||
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| Credential: | FNP-BC | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | UGORJI | ||||||||
| OtherFirstName: | STELLA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2401 DEMERS AVE | ||||||||
| Address2: | |||||||||
| City: | GRAND FORKS | ||||||||
| State: | ND | ||||||||
| PostalCode: | 58201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7017801891 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1001 7TH ST. NE- ALTRU CLINIC DEVILS LAKE | ||||||||
| Address2: | |||||||||
| City: | DEVILS LAKE | ||||||||
| State: | ND | ||||||||
| PostalCode: | 583012719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7016622157 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2017 | ||||||||
| LastUpdateDate: | 09/24/2020 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R47975 | ND | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | AP135739 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.