Provider Demographics
NPI:1891778791
Name:ANYANWU, BIBIANA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:BIBIANA
Middle Name:
Last Name:ANYANWU
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 GRANNY SMITH CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-1749
Mailing Address - Country:US
Mailing Address - Phone:410-391-7331
Mailing Address - Fax:410-391-7331
Practice Address - Street 1:16 GRANNY SMITH CT
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21220-1749
Practice Address - Country:US
Practice Address - Phone:443-717-4762
Practice Address - Fax:443-717-4762
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR121315363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD477109100Medicaid
MD256670ZDNAMedicare Oscar/Certification