Provider Demographics
NPI:1700599164
Name:ANIAGU, BIBIANA UZOMA (RN)
Entity Type:Individual
Prefix:
First Name:BIBIANA
Middle Name:UZOMA
Last Name:ANIAGU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 GOLD ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-2724
Mailing Address - Country:US
Mailing Address - Phone:617-820-4287
Mailing Address - Fax:
Practice Address - Street 1:81 GOLD ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-2724
Practice Address - Country:US
Practice Address - Phone:617-820-4287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-30
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA258-749163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse