Provider Demographics
NPI:1750852802
Name:ANIKWEM, LOVINA C
Entity Type:Individual
Prefix:
First Name:LOVINA
Middle Name:C
Last Name:ANIKWEM
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 1:28032 EDDIE LN
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3693
Mailing Address - Country:US
Mailing Address - Phone:661-607-3203
Mailing Address - Fax:
Practice Address - Street 1:28032 EDDIE LN
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-3693
Practice Address - Country:US
Practice Address - Phone:661-607-3203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA255980164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse