Provider Demographics
NPI:1831588631
Name:ANOSIKE, NNEOMA (APN-C)
Entity type:Individual
Prefix:
First Name:NNEOMA
Middle Name:
Last Name:ANOSIKE
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2783
Mailing Address - Country:US
Mailing Address - Phone:973-435-6666
Mailing Address - Fax:
Practice Address - Street 1:186 W MARKET ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2783
Practice Address - Country:US
Practice Address - Phone:973-435-6666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-16
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00524500363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner