Ginikanwa Agu, NP
Nurse Practitioner, Family in Irving, TX. Individual provider (NPI-1).
NPI number1396458287
StatusActive
Last updated in NPPESApr 1, 2024
Details
- NPI
- 1396458287
- Entity type
- Individual (NPI-1)
- Name
- Ginikanwa Agu
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 5, 2023
- Certification date
- Mar 31, 2024
- Last updated
- Apr 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 854628 | TX | Yes |
| 363LF0000X | Nurse Practitioner, Family | 1085714 | TX |
Practice location
6121 N Hwy 161 Ste 300Irving, TX 75038-2270
Phone 469-647-4705
Mailing address
Po Box 845347Dallas, TX 75284-7208
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