Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | N0874 | TX |
Y | 2080P0214X | Pediatric Pulmonologist | N0874 | TX |
NPI | 1518905934 |
---|---|
Provider Name | Adaobi Kanu |
First Address | Lubbock, TX 79408-5865 |
Second Address | Lubbock, TX 79410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 03/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02356509 | (05) | NY |
528X41 | EMPIRE BC.BS (01) | NY |
7926444 | AETNA (01) | NY |
H82636 | (02) | NY |