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General NPI Number Information
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NPI Number | 1205585841
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Entity Type | Individual
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Provider Name | NKEM ANI NP
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Gender | Female
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 3006 GRACE AVENUE
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City | BRONX
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State | NY
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Zip | 10469-3229
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Country | US
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Telephone | 347-416-8683
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Fax |
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Provider Business Mailing Address
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Address Line | 3006 GRACE AVENUE
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City | BRONX
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State | NY
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Zip | 10469-3229
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Country | US
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Telephone | 718-219-9218
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 815708
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 405971
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ15072400
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License Number State | NJ
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