Healthcare Provider Details

I. General information

NPI: 1922567114
Provider Name (Legal Business Name): CHIOMA NWACHUKWU RN, PHCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 01/31/2021
Certification Date: 01/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3714 17TH ST NE
WASHINGTON DC
20018-2306
US

IV. Provider business mailing address

3714 17TH ST NE
WASHINGTON DC
20018-2306
US

V. Phone/Fax

Practice location:
  • Phone: 202-291-5556
  • Fax:
Mailing address:
  • Phone: 202-291-5556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN66832
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code364SC1501X
TaxonomyCommunity Health/Public Health Clinical Nurse Specialist
License NumberRN66832
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: