Provider Demographics
NPI:1134522063
Name:ASIAMIGBE, NNEKA (MMS, PA-C)
Entity type:Individual
Prefix:
First Name:NNEKA
Middle Name:
Last Name:ASIAMIGBE
Suffix:
Gender:
Credentials:MMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 S PATTEN RD
Mailing Address - Street 2:
Mailing Address - City:PATTEN
Mailing Address - State:ME
Mailing Address - Zip Code:04765-3007
Mailing Address - Country:US
Mailing Address - Phone:207-538-3700
Mailing Address - Fax:855-849-8457
Practice Address - Street 1:529 S PATTEN RD
Practice Address - Street 2:
Practice Address - City:PATTEN
Practice Address - State:ME
Practice Address - Zip Code:04765-3007
Practice Address - Country:US
Practice Address - Phone:207-538-3700
Practice Address - Fax:855-849-8457
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108090363A00000X
NMPA2014-0081363A00000X
WAPA61220081363A00000X
MEPA2568363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2200836Medicaid
NM390503YNGGMedicare Oscar/Certification