Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Idemudia

Individual provider Licensed Practical Nurse · NPI 1013636612

Charles Idemudia is a Licensed Practical Nurse in Surprise, Arizona. Licensed in Arizona. Registered with an NPI since 2022.

Licensed in
AZ
In the registry since
2022

Practice location Address checks out

16088 W Soft Wind Dr
Surprise, AZ 85387-1668
Phone: (602) 327-6605
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence LP039775 (AZ)

Record details

NPI number1013636612
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 25, 2022
Last updated in NPPESAugust 25, 2022
Certification dateAugust 25, 2022
Mailing address16088 W Soft Wind Dr, Surprise, AZ 85387-1668

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