Provider Demographics
NPI:1891277992
Name:AHANONU, PEACE CHIMEBERE (FNP)
Entity Type:Individual
Prefix:
First Name:PEACE
Middle Name:CHIMEBERE
Last Name:AHANONU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 VANTAGE POINT DR APT 226
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-0520
Mailing Address - Country:US
Mailing Address - Phone:214-909-0812
Mailing Address - Fax:
Practice Address - Street 1:9000 VANTAGE POINT DRIVE
Practice Address - Street 2:APT 226
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-7524
Practice Address - Country:US
Practice Address - Phone:214-909-0812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138183363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily