Provider Demographics
NPI:1992084875
Name:ANYANWU, UGOCHI LOVINA (NP)
Entity type:Individual
Prefix:MRS
First Name:UGOCHI
Middle Name:LOVINA
Last Name:ANYANWU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:UGOCHI
Other - Middle Name:LOVINA
Other - Last Name:OPARAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:50 S B B KING BLVD # 100
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-2626
Mailing Address - Country:US
Mailing Address - Phone:901-436-1381
Mailing Address - Fax:
Practice Address - Street 1:75 BROAD ST RM 815
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-3233
Practice Address - Country:US
Practice Address - Phone:718-391-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305257363LA2200X
NJ26NJ00320400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY12250571OtherCAQH