Provider Demographics
NPI:1871366682
Name:INYAMA, ADANNAYA C (MPAS PA-C)
Entity type:Individual
Prefix:
First Name:ADANNAYA
Middle Name:C
Last Name:INYAMA
Suffix:
Gender:F
Credentials:MPAS PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 W WHEATLAND RD STE 140
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4628
Mailing Address - Country:US
Mailing Address - Phone:833-691-3273
Mailing Address - Fax:
Practice Address - Street 1:402 W WHEATLAND RD STE 140
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4628
Practice Address - Country:US
Practice Address - Phone:833-691-3273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA17297363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant