Provider Demographics
NPI:1912305939
Name:NWANERI, ANNPAULA (RN-BSN)
Entity Type:Individual
Prefix:
First Name:ANNPAULA
Middle Name:
Last Name:NWANERI
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 BRIGHTSEAT RD APT 104
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-3768
Mailing Address - Country:US
Mailing Address - Phone:612-702-5848
Mailing Address - Fax:
Practice Address - Street 1:1702 BRIGHTSEAT RD APT 104
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-3768
Practice Address - Country:US
Practice Address - Phone:612-702-5848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1025208163W00000X
MDR200645163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse