Provider Demographics
NPI:1467656918
Name:ICHO, NANETTE ARIAYEFAH (MD)
Entity Type:Individual
Prefix:DR
First Name:NANETTE
Middle Name:ARIAYEFAH
Last Name:ICHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2745 VIRGINIA PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-4915
Mailing Address - Country:US
Mailing Address - Phone:214-491-4900
Mailing Address - Fax:
Practice Address - Street 1:2730 VIRGINIA PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5088
Practice Address - Country:US
Practice Address - Phone:214-491-4900
Practice Address - Fax:214-914-4966
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8406207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine