Provider Demographics
NPI:1518393495
Name:ACHILIHU, CAROLYN OZICHI (CFNP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:OZICHI
Last Name:ACHILIHU
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:AMAIJIE
Other - Last Name:ACHILIHU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CFNP
Mailing Address - Street 1:8307 KNIGHT RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3905
Mailing Address - Country:US
Mailing Address - Phone:713-796-9955
Mailing Address - Fax:713-796-9779
Practice Address - Street 1:850 S 2ND ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-2112
Practice Address - Country:US
Practice Address - Phone:318-388-1250
Practice Address - Fax:318-398-7218
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07463363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2345966Medicaid