Provider Demographics
NPI:1144981697
Name:AZUBIKE NWANGWU, OGONNA IFEYINWA (ACNP)
Entity type:Individual
Prefix:
First Name:OGONNA
Middle Name:IFEYINWA
Last Name:AZUBIKE NWANGWU
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12500 DALLAS PKWY
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4231
Mailing Address - Country:US
Mailing Address - Phone:469-604-9070
Mailing Address - Fax:469-604-9071
Practice Address - Street 1:12500 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4231
Practice Address - Country:US
Practice Address - Phone:469-604-9070
Practice Address - Fax:469-604-9071
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144260363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care