Provider Demographics
NPI:1225892516
Name:ANIGWE, EMMANUEL (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:ANIGWE
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8213 COTTON PATCH LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-8741
Mailing Address - Country:US
Mailing Address - Phone:501-538-2444
Mailing Address - Fax:
Practice Address - Street 1:8213 COTTON PATCH LN
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-8741
Practice Address - Country:US
Practice Address - Phone:501-538-2444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1151421363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty