Provider Demographics
NPI:1003162116
Name:NWANNA, ROSE
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:NWANNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9506 LERIN LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7582
Mailing Address - Country:US
Mailing Address - Phone:713-397-0696
Mailing Address - Fax:281-561-7325
Practice Address - Street 1:9506 LERIN LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7582
Practice Address - Country:US
Practice Address - Phone:713-397-0696
Practice Address - Fax:281-561-7325
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health