Provider Demographics
NPI:1316375538
Name:KIHWAGA, NAOMI (NP-C/FNP-BC)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:KIHWAGA
Suffix:
Gender:F
Credentials:NP-C/FNP-BC
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:CHEGE/MICKENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:418 BALDWIN AVE APT 31A
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1682
Mailing Address - Country:US
Mailing Address - Phone:973-420-9323
Mailing Address - Fax:
Practice Address - Street 1:418 BALDWIN AVE APT 31A
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1682
Practice Address - Country:US
Practice Address - Phone:973-420-9323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-25
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00463200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily