Provider Demographics
NPI:1477742070
Name:NZEREM-JOHNSON, NKECHI AKUDO (MD)
Entity Type:Individual
Prefix:DR
First Name:NKECHI
Middle Name:AKUDO
Last Name:NZEREM-JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NKECHI
Other - Middle Name:AKUDO
Other - Last Name:NZEREM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:DIGNITY HEALTH MEDICAL PLAZA
Mailing Address - Street 2:8220 WYMARK DRIVE SUITE 200
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757
Mailing Address - Country:US
Mailing Address - Phone:916-667-0600
Mailing Address - Fax:916-683-0166
Practice Address - Street 1:DIGNITY HEALTH MEDICAL PLAZA
Practice Address - Street 2:8220 WYMARK DRIVE SUITE 200
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757
Practice Address - Country:US
Practice Address - Phone:916-667-0600
Practice Address - Fax:916-683-0166
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101364208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics