| Oghenetega Ewefada Vance, FNP | |
|
5825 E Calle Guadalupe, Guadalupe, AZ 85283-2664 | |
| (833) 855-9973 | |
| Not Available |
| Full Name | Oghenetega Ewefada Vance |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 5825 E Calle Guadalupe, Guadalupe, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104416007 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 2150369 (Minnesota) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | F07210101 (Minnesota) | Primary |
| Entity Name | District Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336472448 PECOS PAC ID: 7315086691 Enrollment ID: O20091125000583 |
| Mailing Address | Practice Location Address |
|---|---|
| Oghenetega Ewefada Vance, FNP 5825 E Calle Guadalupe, Guadalupe, AZ 85283-2664 Ph: (480) 344-6000 | Oghenetega Ewefada Vance, FNP 5825 E Calle Guadalupe, Guadalupe, AZ 85283-2664 Ph: (833) 855-9973 |
Ms. Michelle Kay Anderson, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5825 E Calle Guadalupe, Guadalupe, AZ 85283 Phone: 602-344-6000 Fax: 602-344-6001 | |
Erica Carreon, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6725 S Priest Dr, Guadalupe, AZ 85283 Phone: 602-279-5262 |