Provider Demographics
NPI:1427475219
Name:AJANWACHUKU, MELANIE ROSE BROWN
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:ROSE BROWN
Last Name:AJANWACHUKU
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 1:16133 KAMANA RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1377
Mailing Address - Country:US
Mailing Address - Phone:760-242-8491
Mailing Address - Fax:
Practice Address - Street 1:16133 KAMANA RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1377
Practice Address - Country:US
Practice Address - Phone:760-242-8491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic