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NPI Code Detail

MEDICARE: GLORY NWANKWO NP

MEDICARE:   GLORY  NWANKWO  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerA004711AR
2363LP0808XPsychiatric/Mental Health Nurse PractitionerA004711AR

General Provider Information

NPI Number : 1396195996
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLORY NWANKWO NP
Provider Business Mailing Address
First Line : 600 1ST AVE STE 102
Second Line :
City : SEATTLE
State : WA
Zip : 98104-2287
Country : US
Telephone Number : 206-561-3933
Fax Number : 206-895-1274
Provider Business Practice Location Address
First Line : 600 1ST AVE STE 102
Second Line :
City : SEATTLE
State : WA
Zip : 98104-2287
Country : US
Telephone Number : 206-895-1259
Fax Number : 206-895-1274
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2016
Last Update Date : 07/19/2023

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Directions to “ GLORY NWANKWO NP” Practice Location

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