Provider Demographics
NPI:1417452186
Name:OPARA, ANNA OGECHUKWU
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:OGECHUKWU
Last Name:OPARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 DOVER GLEN DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-1498
Mailing Address - Country:US
Mailing Address - Phone:325-864-5699
Mailing Address - Fax:702-323-0898
Practice Address - Street 1:5550 W FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2334
Practice Address - Country:US
Practice Address - Phone:325-864-5699
Practice Address - Fax:702-323-0898
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health