Provider Demographics
NPI:1457886582
Name:ANYANWU, EMILIA NGOZI (NP)
Entity Type:Individual
Prefix:
First Name:EMILIA
Middle Name:NGOZI
Last Name:ANYANWU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 TROON DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-7896
Mailing Address - Country:US
Mailing Address - Phone:469-443-2810
Mailing Address - Fax:
Practice Address - Street 1:1350 N WESTMORELAND RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-1654
Practice Address - Country:US
Practice Address - Phone:214-331-0107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133180363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily