Provider Demographics
NPI:1669814968
Name:CHIKELU, FAVOR NGOZI
Entity Type:Individual
Prefix:
First Name:FAVOR
Middle Name:NGOZI
Last Name:CHIKELU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 CALICO HEARTS CT
Mailing Address - Street 2:LAS VEGAS
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-1443
Mailing Address - Country:US
Mailing Address - Phone:702-772-3663
Mailing Address - Fax:
Practice Address - Street 1:2617 CALICO HEARTS CT
Practice Address - Street 2:LAS VEGAS
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-1443
Practice Address - Country:US
Practice Address - Phone:702-772-3663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-27
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator