Provider Demographics
NPI:1073889143
Name:ANYAOHA, MAUREEN U (RN)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:U
Last Name:ANYAOHA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 PADDOCKS WAY
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-5500
Mailing Address - Country:US
Mailing Address - Phone:770-856-2522
Mailing Address - Fax:
Practice Address - Street 1:1410 PADDOCKS WAY
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-5500
Practice Address - Country:US
Practice Address - Phone:770-856-2522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN212219163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent