Individual
IKENNA CHIDUM ANYABOLU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3513 OLD HOLLY DR, PEARLAND, TX 77584-1933
(513) 442-6044
Mailing address
10727 RIVER WALK DR, MISSOURI CITY, TX 77459-5524
(513) 442-6044
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1143408
TX
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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