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General NPI Number Information
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NPI Number | 1043630742
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Entity Type | Individual
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Provider Name | BAOANH CHU
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Gender | Male
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Dates
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Enumeration Date | 04/21/2014
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Last Update Date | 09/27/2017
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Provider Practice Location Address
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Address Line | 6150 OAK TREE BLVD STE 200
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City | INDEPENDENCE
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State | OH
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Zip | 44131-2569
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Country | US
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Telephone | 954-850-3444
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 821605
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City | PEMBROKE PINES
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State | FL
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Zip | 33082-1605
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | ARNP9277780
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9277780
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License Number State | FL
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