Healthcare Provider Details

I. General information

NPI: 1013200484
Provider Name (Legal Business Name): UCHENNA ANTHONIA OBICHERE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2011
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 VARNUM ST NE SUITE 317
WASHINGTON DC
20017-2107
US

IV. Provider business mailing address

9313 FRENSHAM CT
LAUREL MD
20708-2856
US

V. Phone/Fax

Practice location:
  • Phone: 202-636-1130
  • Fax: 202-636-1132
Mailing address:
  • Phone: 301-497-1870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR137135
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN66925
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR137135
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR137135
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: