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CHARLES IDEMUDIA
NPI 1013636612
Licensed Practical Nurse in Surprise, AZ

Active since August 25, 2022
16088 W SOFT WIND DR, SURPRISE, AZ 85387(602) 327-6605 Get Directions Write a Review

NPPES record last updated: August 25, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Charles Idemudia NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES IDEMUDIA (NPI 1013636612) is an individual licensed practical nurse in Surprise, Arizona, licensed in Arizona (LP039775) and active in the NPI registry since August 2022.

NPPES Registry Identity

NPI1013636612
Entity TypeIndividualMale
Primary Taxonomy164W00000X
Provider Legal NameCHARLES IDEMUDIA
Location Address16088 W SOFT WIND DRSurprise, AZ 85387-1668
Mailing Address16088 W Soft Wind DrSurprise, AZ 85387-1668 · (602) 327-6605
Phone(602) 327-6605
Sole ProprietorNo
Enumeration DateAugust 25, 2022
NPPES CertifiedAugust 25, 2022
✔ NPI 1013636612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in AZ · LP039775
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
16088 W SOFT WIND DR, Surprise, AZ 85387
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUPREME HEALTHCARE LLC
Nursing Care
16088 W SOFT WIND DR
SURPRISE, AZ 85387
Maricopa County (602) 327-6605

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Idemudia's NPI number?

The NPI number for Charles Idemudia is 1013636612. It was assigned to this individual provider in the NPPES registry on August 25, 2022.

Where is Charles Idemudia located?

Charles Idemudia practices at 16088 W Soft Wind Dr, Surprise, AZ 85387. The listed phone number is (602) 327-6605.

What is Charles Idemudia's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Charles Idemudia was last updated on August 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.