Provider Demographics
NPI:1851027320
Name:ANUMBA, JAMIE NKECHIYERE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:NKECHIYERE
Last Name:ANUMBA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1979 SOMERSET BLVD APT 213
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3945
Mailing Address - Country:US
Mailing Address - Phone:248-469-6537
Mailing Address - Fax:
Practice Address - Street 1:1979 SOMERSET BLVD APT 213
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3945
Practice Address - Country:US
Practice Address - Phone:248-469-6537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704322481363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily