Healthcare Provider Details

I. General information

NPI: 1760318265
Provider Name (Legal Business Name): CHIJIOKE ANCHILLA NWANERI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 NE WOODVIEW LN
LEES SUMMIT MO
64086-7817
US

IV. Provider business mailing address

1801 NE WOODVIEW LN
LEES SUMMIT MO
64086-7817
US

V. Phone/Fax

Practice location:
  • Phone: 816-694-7866
  • Fax:
Mailing address:
  • Phone: 816-694-7866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberIA-0008404284
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: