Provider Demographics
NPI:1922385954
Name:NWAOZUZU, BRAIN U (CNP)
Entity Type:Individual
Prefix:
First Name:BRAIN
Middle Name:U
Last Name:NWAOZUZU
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3702 AVONDALE RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4504
Mailing Address - Country:US
Mailing Address - Phone:216-767-4254
Mailing Address - Fax:
Practice Address - Street 1:13944 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-3832
Practice Address - Country:US
Practice Address - Phone:216-767-4254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2010005436363LF0000X
OH20100161363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics