Healthcare Provider Details

I. General information

NPI: 1194550137
Provider Name (Legal Business Name): CHIOMA NNEAMAKA AKANDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5422 W THUNDERBIRD RD STE 8
GLENDALE AZ
85306-4717
US

IV. Provider business mailing address

5422 W THUNDERBIRD RD STE 8
GLENDALE AZ
85306-4717
US

V. Phone/Fax

Practice location:
  • Phone: 480-718-5072
  • Fax:
Mailing address:
  • Phone: 480-718-5072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number221907
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: