Healthcare Provider Details

I. General information

NPI: 1730799040
Provider Name (Legal Business Name): ENOCH ANYANWU PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 STANLEY ST
FALL RIVER MA
02720-6009
US

IV. Provider business mailing address

77 VINE STREET WEYMOUTH
WEYMOUTH MA
02188
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-5222
  • Fax: 508-324-7777
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2278399
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number2020016554
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: