Provider Demographics
NPI:1740952787
Name:NWEZE, MARGARET NGOZI
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:NGOZI
Last Name:NWEZE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:NGOZI
Other - Last Name:MBA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:4406 ROOT WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3045
Mailing Address - Country:US
Mailing Address - Phone:734-218-3624
Mailing Address - Fax:
Practice Address - Street 1:8303 BRIMHALL RD BLDG 1500
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2243
Practice Address - Country:US
Practice Address - Phone:661-587-2468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95259819163W00000X
261QP3300X
CA95018692363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95018692OtherNURSE PRACTITIONER LICENSE