MEDICARE: MRS. MARY C. ANYANWU

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
1	163WH0200X	Home Health Registered Nurse	RN483980	OH

General Provider Information

NPI Number	:	1306656368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY C. ANYANWU

Provider Business Mailing Address
First Line	:	1349 SPRING PARK WALK
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-0046
Country	:	US
Telephone Number	:	616-634-8122
Fax Number	:

Provider Business Practice Location Address
First Line	:	1349 SPRING PARK WALK
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-0046
Country	:	US
Telephone Number	:	616-634-8122
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2025
Last Update Date	:	01/11/2025

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