| Doctor Name: | DR. NKECHINYELU VIVIAN NNEBE |
| NPI Number: | 1982886123 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | MD2009-0207 |
| Business Practice Address: | 407 S Schwartz Ave Suite 102 Farmington, NM - 874015925 |
| Business Phone Number: | 5056096700 |
| Business Fax Number: | 5056096701 |
| Mailing Address: | Po Box 6210, FARMINGTON |
| State: | NM |
| Postal Code: | 874996210 |
| Phone Number: | 5056092258 |
| Fax Number: | 5056092259 |
| NPI Enumeration Date: | 11/29/2007 |
| NPI Last Update Date: | 04/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | MD2009-0207 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |