Healthcare Provider Details

I. General information

NPI: 1700477981
Provider Name (Legal Business Name): AMARA ONUORAH PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2021
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11111 HOUZE RD STE 201&225
ROSWELL GA
30076-5663
US

IV. Provider business mailing address

11111 HOUZE RD STE 201&225
ROSWELL GA
30076-5663
US

V. Phone/Fax

Practice location:
  • Phone: 678-833-0502
  • Fax: 253-254-5911
Mailing address:
  • Phone: 678-833-0502
  • Fax: 253-254-5911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP255017
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN255017
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: