Provider Demographics
NPI:1013382373
Name:ANUKAM, JOAN NKECHI (FNP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:NKECHI
Last Name:ANUKAM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6041 CADILLAC AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-1702
Mailing Address - Country:US
Mailing Address - Phone:323-857-3236
Mailing Address - Fax:
Practice Address - Street 1:10835 NEW ST
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3714
Practice Address - Country:US
Practice Address - Phone:562-923-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-11
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR213786363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily