Healthcare Provider Details

I. General information

NPI: 1285490532
Provider Name (Legal Business Name): ADAKU MONICA CHIKEZIE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 02/26/2024
Certification Date: 02/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 CHESTNUT ST
SPRINGFIELD MA
01107-2007
US

IV. Provider business mailing address

97 FLORENCE ST
SPRINGFIELD MA
01105-1509
US

V. Phone/Fax

Practice location:
  • Phone: 413-356-0987
  • Fax:
Mailing address:
  • Phone: 413-356-0987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN2344159
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: