Provider Demographics
NPI:1760749543
Name:AWUNGNJIA, HANNIBAL (APRNCNP)
Entity Type:Individual
Prefix:
First Name:HANNIBAL
Middle Name:
Last Name:AWUNGNJIA
Suffix:
Gender:M
Credentials:APRNCNP
Other - Prefix:
Other - First Name:HANNIBAL
Other - Middle Name:
Other - Last Name:AWUNGNJIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRNCNP
Mailing Address - Street 1:12203 TAYLORS WAY
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9964
Mailing Address - Country:US
Mailing Address - Phone:202-683-0612
Mailing Address - Fax:
Practice Address - Street 1:12203 TAYLORS WAY
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9964
Practice Address - Country:US
Practice Address - Phone:202-683-0612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0034725363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care