Provider Demographics
NPI:1417482670
Name:KANU, EUNICE (NP)
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:
Last Name:KANU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EUNICE
Other - Middle Name:
Other - Last Name:KANU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:720 AVENUE F N STE 3
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-9574
Mailing Address - Country:US
Mailing Address - Phone:979-245-9797
Mailing Address - Fax:
Practice Address - Street 1:720 AVENUE F N STE 3
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-9574
Practice Address - Country:US
Practice Address - Phone:979-245-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133116163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice