Provider Demographics
NPI:1649438425
Name:AGINA, HYACINTHA EYIUCHE (NP)
Entity type:Individual
Prefix:
First Name:HYACINTHA
Middle Name:EYIUCHE
Last Name:AGINA
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 1:4929 E KINGS CANYON RD
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-3812
Mailing Address - Country:US
Mailing Address - Phone:559-255-6476
Mailing Address - Fax:
Practice Address - Street 1:4929 E KINGS CANYON RD
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-3812
Practice Address - Country:US
Practice Address - Phone:559-255-6476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 14929363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP 14929OtherSTATE OF CALIFORNIA BOARD OF REGISTERED NURSING