MEDICARE: IJEOMA GLADYS OLEWE RN, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	0001284892	VA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024193440	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0024193440	OTHER	VA	VABON

General Provider Information

NPI Number	:	1093446783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IJEOMA GLADYS OLEWE RN, PMHNP-BC

Provider Business Mailing Address
First Line	:	1806 SUMMIT AVE STE 300
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-4339
Country	:	US
Telephone Number	:	540-514-3824
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 E PARHAM RD STE 102
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23228-2234
Country	:	US
Telephone Number	:	804-799-9292
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	02/26/2026

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