Provider Demographics
NPI:1629233739
Name:ANAGBOGU, MERCY OBIOMA (RN)
Entity Type:Individual
Prefix:
First Name:MERCY
Middle Name:OBIOMA
Last Name:ANAGBOGU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 GEORGETOWNE DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-1847
Mailing Address - Country:US
Mailing Address - Phone:919-763-0159
Mailing Address - Fax:919-763-0159
Practice Address - Street 1:208 GEORGETOWNE DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-1847
Practice Address - Country:US
Practice Address - Phone:919-763-0159
Practice Address - Fax:919-763-0159
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC204559163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse