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NPI Code Detail

MEDICARE: NNEKA ANYANWU NP

MEDICARE: NNEKA ANYANWU NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner95020950CA
2363LF0000XFamily Nurse Practitioner1098553TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11098553OTHERTXTEXAS NP LICENSE
295020950OTHERCAFURNISHING NUMBER

General Provider Information

NPI Number : 1124753405
Entity Type Code : Individual
Provider Name (Legal Business Name) : NNEKA ANYANWU NP
Provider Business Mailing Address
First Line : 5604 TARES CIR
Second Line :
City : ELK GROVE
State : CA
Zip : 95757-4362
Country : US
Telephone Number : 225-921-0851
Fax Number :
Provider Business Practice Location Address
First Line : 3033 CHIMNEY ROCK RD STE 519
Second Line :
City : HOUSTON
State : TX
Zip : 77056-6260
Country : US
Telephone Number : 832-280-4054
Fax Number : 832-699-7989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2022
Last Update Date : 06/19/2025

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