Healthcare Provider Details

I. General information

NPI: 1336364082
Provider Name (Legal Business Name): NGOZI MEWE-PIRA RN, BSN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NGOZI MEWE-PIRA FNP-BC

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 10/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 KERNAN DR
BALTIMORE MD
21207-6665
US

IV. Provider business mailing address

2200 KERNAN DR ATTN: CREDENTIALING DPT
BALTIMORE MD
21207-6665
US

V. Phone/Fax

Practice location:
  • Phone: 410-448-6824
  • Fax: 410-448-6825
Mailing address:
  • Phone: 410-448-6824
  • Fax: 410-448-6825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR162467
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number094102
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR162467
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number004395
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: