Provider Demographics
NPI:1801578018
Name:NWAKA, TERRICA SHYNIESE
Entity type:Individual
Prefix:MRS
First Name:TERRICA
Middle Name:SHYNIESE
Last Name:NWAKA
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 1:1 SWANSON WAY
Mailing Address - Street 2:
Mailing Address - City:BURY ST. EDMUNDS
Mailing Address - State:UNITED KINGDOM
Mailing Address - Zip Code:IP32 7QP
Mailing Address - Country:GB
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ERISWELL ROAD, BUILDING 944
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:UNITED KINGDOM
Practice Address - Zip Code:IP27 9PN
Practice Address - Country:GB
Practice Address - Phone:314-226-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant