Provider Demographics
NPI:1275862633
Name:ASONGACHA, ANYI EA (MSN, PMHNP)
Entity Type:Individual
Prefix:
First Name:ANYI
Middle Name:EA
Last Name:ASONGACHA
Suffix:
Gender:F
Credentials:MSN, PMHNP
Other - Prefix:
Other - First Name:ALEMNJI
Other - Middle Name:ERNESTINE ANYI
Other - Last Name:ASONGACHA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:2845 BELL ST
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1720
Mailing Address - Country:US
Mailing Address - Phone:740-454-9766
Mailing Address - Fax:740-588-6236
Practice Address - Street 1:2845 BELL ST
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1720
Practice Address - Country:US
Practice Address - Phone:740-454-9766
Practice Address - Fax:740-588-6236
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH379633163W00000X
OH0027900363LP0808X, 363LP0808X
OH126774164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0433152Medicaid