Provider Demographics
NPI:1932884137
Name:ONYIA, NNEKA MARIAGORETTI
Entity Type:Individual
Prefix:
First Name:NNEKA
Middle Name:MARIAGORETTI
Last Name:ONYIA
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 1:1215 N IVY LOOP STE 101
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5406
Mailing Address - Country:US
Mailing Address - Phone:480-544-4400
Mailing Address - Fax:480-534-6706
Practice Address - Street 1:1215 N IVY LOOP STE 101
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5406
Practice Address - Country:US
Practice Address - Phone:480-544-4400
Practice Address - Fax:480-534-6706
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ292817363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health