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Individual

MR. CHYNWE CELESTINE AHUMARAEZE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ARNP

Contact information

Practice address
17844 E 23RD ST S, INDEPENDENCE, MO 64057-1840
(816) 254-3652
(816) 254-9243
Mailing address
17844 E 23RD ST S, INDEPENDENCE, MO 64057-1840
(816) 254-3652
(816) 254-9243

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2012001791
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1942572540
MO
Enumeration date
01/30/2012
Last updated
09/10/2012
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