Provider Demographics
NPI:1306437231
Name:ANYAKORA-OKAFOR, ANTHONIA
Entity type:Individual
Prefix:
First Name:ANTHONIA
Middle Name:
Last Name:ANYAKORA-OKAFOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANTHONIA
Other - Middle Name:IFEYINWA
Other - Last Name:ANYAKORA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN/ED, BSN, PHN ,RN
Mailing Address - Street 1:518 S SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-6830
Mailing Address - Country:US
Mailing Address - Phone:909-252-3573
Mailing Address - Fax:
Practice Address - Street 1:518 S SPRUCE AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-6830
Practice Address - Country:US
Practice Address - Phone:909-252-3573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA544873163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse