Provider Demographics
NPI:1649531526
Name:ANYAFULU, NKESI D
Entity type:Individual
Prefix:
First Name:NKESI
Middle Name:D
Last Name:ANYAFULU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5580 JAY ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-7027
Mailing Address - Country:US
Mailing Address - Phone:202-718-0227
Mailing Address - Fax:
Practice Address - Street 1:3341 BENNING RD NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1502
Practice Address - Country:US
Practice Address - Phone:202-718-0227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
DCNP1044915363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No374U00000XNursing Service Related ProvidersHome Health Aide