Provider Demographics
NPI:1336438530
Name:KANU, ANGELA OGONNAYA (PHD, RPH)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:OGONNAYA
Last Name:KANU
Suffix:
Gender:F
Credentials:PHD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 STAGE FORD RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-1826
Mailing Address - Country:US
Mailing Address - Phone:919-539-8805
Mailing Address - Fax:
Practice Address - Street 1:8841 SIX FORKS RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2970
Practice Address - Country:US
Practice Address - Phone:919-539-8805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12615183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist