Most Relevant Information
Provider Data
| NPI Number: | 1003379959 |
| Provider Name: | KENNETH EZENWA RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WP0808X |
| Specialty: | Registered Nurse |
| License Number: | 95080178 |
Most Important Dates
| Enumeration Date: | 04/08/2019 |
| Last Updated: | 02/08/2022 |
Provider Practice Location
17467 HONEY MAPLE ST
CANYON COUNTRY
CA
913876870
Practice Location Phone/Fax
| Phone: | 6612125273 |
| Fax: |
Provider Mailing Location
17467 HONEY MAPLE ST
CANYON COUNTRY
CA
913876870
Provider Mailing Phone/Fax
| Phone: | 6612125273 |
| Fax: |