Provider Demographics
NPI:1780027946
Name:KALU, PATRICIA NGOZI (ARNP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:NGOZI
Last Name:KALU
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6344 PICKNEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312
Mailing Address - Country:US
Mailing Address - Phone:850-668-4405
Mailing Address - Fax:
Practice Address - Street 1:8501 HAMPTON SPRINGS RD
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32348
Practice Address - Country:US
Practice Address - Phone:850-838-4272
Practice Address - Fax:850-838-4287
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2971552363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner