Provider Demographics
NPI:1265025332
Name:ANYAEJI, GLORIA AHUNNA (NP-C)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:AHUNNA
Last Name:ANYAEJI
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8311 W CANVASBACK LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85757-6826
Mailing Address - Country:US
Mailing Address - Phone:520-331-7462
Mailing Address - Fax:
Practice Address - Street 1:8311 W CANVASBACK LN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85757-6826
Practice Address - Country:US
Practice Address - Phone:520-331-7462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ252274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily