Provider Demographics
NPI:1861653263
Name:AGUOCHA, NNENNA NKECHINYERE (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:NNENNA
Middle Name:NKECHINYERE
Last Name:AGUOCHA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 FRANKLIN ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:565-390-4572
Mailing Address - Fax:
Practice Address - Street 1:2006 FRANKLIN ST SE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4537
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0737082085R0202X
TN557052085R0202X
AL359502085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL243302Medicaid
AL243592Medicaid
AL199636Medicaid
AL200099Medicaid
AL201214Medicaid
AL212768Medicaid
AL243359Medicaid
AL200343Medicaid
AL201273Medicaid
AL243282Medicaid
AL266246Medicaid
AL199106Medicaid
AL243356Medicaid
AL200976Medicaid
AL245499Medicaid