Provider Demographics
NPI:1821589979
Name:ANYAEGBU, BLESSING CHIOMA JR (LVN)
Entity Type:Individual
Prefix:
First Name:BLESSING
Middle Name:CHIOMA
Last Name:ANYAEGBU
Suffix:JR
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 N JUPITER RD APT 2066
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-8649
Mailing Address - Country:US
Mailing Address - Phone:469-662-1144
Mailing Address - Fax:
Practice Address - Street 1:1650 N JUPITER RD APT 2066
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-8649
Practice Address - Country:US
Practice Address - Phone:469-662-1144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX308052164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse