Organization
CHINANY CARE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHINOMSO D EZENWATA APRN (PRESIDENT / PROVIDER)
(702) 415-9760
Entity
Organization
Contact information
Practice address
3110 S DURANGO DR STE 200, LAS VEGAS, NV 89117
(702) 415-9760
(702) 478-6211
Mailing address
PO BOX 30771, LAS VEGAS, NV 89173-0771
(702) 415-9760
(702) 478-6211
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN001829
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851785828
—
NV
01
—
V112538
MEDICARE PTAN
NV
Enumeration date
02/06/2016
Last updated
09/04/2021
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