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General NPI Number Information
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NPI Number | 1942572540
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Entity Type | Individual
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Provider Name | CHYNWE CELESTINE AHUMARAEZE ARNP
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Gender | Male
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Dates
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Enumeration Date | 01/30/2012
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 17844 E 23RD ST S
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City | INDEPENDENCE
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State | MO
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Zip | 64057-1840
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Country | US
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Telephone | 816-254-3652
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Fax | 816-254-9243
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Provider Business Mailing Address
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Address Line | 17844 E 23RD ST S
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City | INDEPENDENCE
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State | MO
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Zip | 64057-1840
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Country | US
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Telephone | 816-254-3652
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Fax | 816-254-9243
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2012001791
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License Number State | MO
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