Provider Demographics
NPI:1568718450
Name:ONWUSIBE, JOY CHINENYENWA (NP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:CHINENYENWA
Last Name:ONWUSIBE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 MAGAW LN
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-5629
Mailing Address - Country:US
Mailing Address - Phone:770-222-7075
Mailing Address - Fax:770-222-7035
Practice Address - Street 1:600 W MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-4117
Practice Address - Country:US
Practice Address - Phone:770-445-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN162813363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health