MEDICARE: MRS. PEACEMAKER NWAMAKA MGBOJI RN

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	363L00000X	Nurse Practitioner	R128764	MD
2	163W00000X	Registered Nurse	R128764	MD

General Provider Information

NPI Number	:	1396693677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PEACEMAKER NWAMAKA MGBOJI RN

Provider Business Mailing Address
First Line	:	214 OAK VALLEY DR
Second Line	:
City	:	BEL AIR
State	:	MD
Zip	:	21014-5941
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 OAK VALLEY DR
Second Line	:
City	:	BEL AIR
State	:	MD
Zip	:	21014-5941
Country	:	US
Telephone Number	:	410-318-9167
Fax Number	:

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

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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