Provider Demographics
NPI:1598000200
Name:NNANJI, CHINMAEZE WACHUKU (APN)
Entity Type:Individual
Prefix:MS
First Name:CHINMAEZE
Middle Name:WACHUKU
Last Name:NNANJI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MRS
Other - First Name:ROSE
Other - Middle Name:NWANGOZI
Other - Last Name:OKPARANTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:221 BOOTHBY CT
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2504
Mailing Address - Country:US
Mailing Address - Phone:856-481-4307
Mailing Address - Fax:
Practice Address - Street 1:221 BOOTHBY CT
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2504
Practice Address - Country:US
Practice Address - Phone:856-481-4307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00294400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily