Provider Demographics
NPI:1841359072
Name:NWOGU, CECILIA A (NP)
Entity type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:A
Last Name:NWOGU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3001 S COBB DR SE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-7809
Mailing Address - Country:US
Mailing Address - Phone:678-556-9460
Mailing Address - Fax:678-556-9462
Practice Address - Street 1:3001 S COBB DR SE
Practice Address - Street 2:SUITE 103
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-7809
Practice Address - Country:US
Practice Address - Phone:678-556-9460
Practice Address - Fax:678-556-9462
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN113098363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner