Healthcare Provider Details

I. General information

NPI: 1174356216
Provider Name (Legal Business Name): ANNE NJOKU DNP, FNP-C, BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WEST COAST ROAD #B
REDWAY CA
95560
US

IV. Provider business mailing address

2704 PONTEVERDE LN
DAVIS CA
95618-6572
US

V. Phone/Fax

Practice location:
  • Phone: 707-923-2783
  • Fax:
Mailing address:
  • Phone: 916-606-2124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95031170
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: