Provider Demographics
NPI:1205393360
Name:AZU, NGOZI (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NGOZI
Middle Name:
Last Name:AZU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:NGOZI
Other - Middle Name:ANNE
Other - Last Name:NWOGU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 JONQUIL WAY
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4102
Mailing Address - Country:US
Mailing Address - Phone:215-284-1567
Mailing Address - Fax:
Practice Address - Street 1:301 SPRING GARDEN RD
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-9699
Practice Address - Country:US
Practice Address - Phone:609-561-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR12890500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily