MEDICARE: MICHAEL CHUKS NNAMANI

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	783641	TX

General Provider Information

NPI Number	:	1639577745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CHUKS NNAMANI

Provider Business Mailing Address
First Line	:	929 PECAN TRL
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-3169
Country	:	US
Telephone Number	:	214-924-1594
Fax Number	:	972-291-2352

Provider Business Practice Location Address
First Line	:	929 PECAN TRL
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-3169
Country	:	US
Telephone Number	:	214-924-1594
Fax Number	:	972-291-2352

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

Provider Enumeration Date	:	12/05/2014
Last Update Date	:	12/05/2014

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