Healthcare Provider Details

I. General information

NPI: 1619846763
Provider Name (Legal Business Name): CHIDIMA ORANEKWU PMHNP-BC
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 SALEM ST STE 201
READING MA
01867-4614
US

IV. Provider business mailing address

10 CAYUGA RD
TEWKSBURY MA
01876-1215
US

V. Phone/Fax

Practice location:
  • Phone: 435-764-0756
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2311824
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: