MEDICARE: MRS. ALICE CHINYERE UKAEGBU NP

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	RN55058	DC
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	867940	NY
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ14865400	NJ
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024184379	VA
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R102922	MD

General Provider Information

NPI Number	:	1477881548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALICE CHINYERE UKAEGBU NP

Provider Business Mailing Address
First Line	:	7514 EASTERN AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20012-1822
Country	:	US
Telephone Number	:	202-829-4269
Fax Number	:	202-829-4269

Provider Business Practice Location Address
First Line	:	8120 FENTON ST STE 204
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4753
Country	:	US
Telephone Number	:	202-531-2607
Fax Number	:

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

Provider Enumeration Date	:	11/30/2009
Last Update Date	:	04/25/2025

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