Healthcare Provider Details

I. General information

NPI: 1447589643
Provider Name (Legal Business Name): RITA CHIOMA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2009
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 PENNSYLVANIA AVE SE
WASHINGTON DC
20020-3865
US

IV. Provider business mailing address

12530 FAIRWOOD PKWY STE 102
BOWIE MD
20720-6357
US

V. Phone/Fax

Practice location:
  • Phone: 301-213-4405
  • Fax: 301-560-5140
Mailing address:
  • Phone: 301-213-4405
  • Fax: 301-560-5140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR123308
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP63547
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN63547
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: