Healthcare Provider Details

I. General information

NPI: 1811157027
Provider Name (Legal Business Name): NKECHI AHANOTU-ANIGBOGU RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NKECHI AHANOTU

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2646 SOUTH LOOP WEST SUITE 355
HOUSTON TX
77054-2665
US

IV. Provider business mailing address

2218 SILVER LEAF DRIVE
MISSOURI CITY TX
77489-5029
US

V. Phone/Fax

Practice location:
  • Phone: 713-218-7099
  • Fax: 713-218-6772
Mailing address:
  • Phone: 713-218-7099
  • Fax: 713-218-6772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number008197
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: