Healthcare Provider Details

I. General information

NPI: 1649028127
Provider Name (Legal Business Name): OZIOMA OBIMA-NWALI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2024
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 M ST NW
WASHINGTON DC
20037
US

IV. Provider business mailing address

5 GARRETT AVE
LA PLATA MD
20646-5960
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR218282
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP1042679
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: