MEDICARE: ALOZIE ANGUS ASIKA

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
1	363LG0600X	Gerontology Nurse Practitioner	4704328727NSA24097	MI
2	363LA2200X	Adult Health Nurse Practitioner	4704328727NSA24097	MI

General Provider Information

NPI Number	:	1568219756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALOZIE ANGUS ASIKA

Provider Business Mailing Address
First Line	:	3829 WESTCHESTER BLVD
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-1171
Country	:	US
Telephone Number	:	734-604-0506
Fax Number	:

Provider Business Practice Location Address
First Line	:	3829 WESTCHESTER BLVD
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-1171
Country	:	US
Telephone Number	:	734-604-0506
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2024
Last Update Date	:	05/04/2024

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Directions to “ ALOZIE ANGUS ASIKA ” Practice Location

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