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General NPI Number Information
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NPI Number | 1841359072
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Entity Type | Individual
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Provider Name | CECILIA A NWOGU N.P.
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Gender | Female
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 10/12/2025
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Provider Practice Location Address
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Address Line | 3001 S COBB DR SE SUITE 103
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City | SMYRNA
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State | GA
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Zip | 30080-7809
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Country | US
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Telephone | 678-556-9460
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Fax | 678-556-9462
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Provider Business Mailing Address
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Address Line | 848 HIRAM ACWORTH HWY STE A
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City | HIRAM
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State | GA
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Zip | 30141-2399
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Country | US
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Telephone | 678-324-7021
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Fax | 678-401-3016
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN113098
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License Number State | GA
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