Provider Demographics
NPI:1619275815
Name:MOLOKWU, ANNE ANWULI (LVN)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:ANWULI
Last Name:MOLOKWU
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13363 PRECIADO AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4911
Mailing Address - Country:US
Mailing Address - Phone:909-590-8179
Mailing Address - Fax:
Practice Address - Street 1:13363 PRECIADO AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4911
Practice Address - Country:US
Practice Address - Phone:909-590-8179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208277164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse