Provider Demographics
NPI:1588837090
Name:AHANONU, JOY CHIZOBAM (CRNP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:CHIZOBAM
Last Name:AHANONU
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 W ROLLING XRDS STE 100
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6277
Mailing Address - Country:US
Mailing Address - Phone:410-869-0100
Mailing Address - Fax:410-601-7317
Practice Address - Street 1:4 W ROLLING CROSS RD STE 100
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6280
Practice Address - Country:US
Practice Address - Phone:410-869-0100
Practice Address - Fax:410-601-7317
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR159676363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care