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General NPI Number Information
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NPI Number | 1225282379
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Entity Type | Individual
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Provider Name | JOHN NKENCHO NWAEZEAPU CRNA
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Gender | Male
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 6500 13TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20012-2904
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Country | US
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Telephone | 202-726-0420
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Fax |
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Provider Business Mailing Address
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Address Line | 6500 13TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20012-2904
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Country | US
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Telephone | 202-726-0420
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R129485
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN63042
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License Number State | DC
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