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General NPI Number Information
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NPI Number | 1063013605
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Entity Type | Individual
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Provider Name | OGECHI ANN OHIA AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/02/2020
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 12361 W BOLA DR STE 109
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City | SURPRISE
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State | AZ
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Zip | 85378-9021
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Country | US
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Telephone | 623-227-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 2626 DEERWOOD HEIGHTS LN
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City | MANVEL
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State | TX
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Zip | 77578-2058
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Country | US
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Telephone | 414-659-3333
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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 | AP143724
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License Number State | TX
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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 | AP143724
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License Number State | TX
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