Provider Demographics
NPI:1689427791
Name:AKAMNONU, IKENNA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:IKENNA
Middle Name:
Last Name:AKAMNONU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:IKE
Other - Middle Name:
Other - Last Name:AKAMNONU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:139 SUMMIT CT
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3396
Mailing Address - Country:US
Mailing Address - Phone:817-489-4443
Mailing Address - Fax:
Practice Address - Street 1:139 SUMMIT CT
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3396
Practice Address - Country:US
Practice Address - Phone:817-489-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX693401835P1200X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy