Individual provider · NPI-1

Nnenna Egbuna, Physician Assistant

Physician Assistant · Lithonia, GA

NPI number1215440136
StatusActive
Last updated in NPPESOct 20, 2023

Details

NPI
1215440136
Entity type
Individual (NPI-1)
Name
Ms. Nnenna Egbuna
Credential
Physician Assistant
Sex
Female
Sole proprietor
No
Enumeration date
Nov 14, 2017
Certification date
Oct 20, 2023
Last updated
Oct 20, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant8567GAYes
363A00000X Physician Assistant58115CA

Practice location

7231 Rockbridge Rd
Lithonia, GA 30058-5918

Phone 678-710-9270

Mailing address

3559 E South St
Lakewood, CA 90805-4519

Other practice locations

3559 E South St
Lakewood, CA 90805-4519

Phone 562-354-4410

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