Healthcare Provider Details

I. General information

NPI: 1710873344
Provider Name (Legal Business Name): BLESSING NNENNA CHUKWU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 N WOLFE ST
BALTIMORE MD
21205-2110
US

IV. Provider business mailing address

76 71ST ST FRNT HOUSE
GUTTENBERG NJ
07093-4704
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-4766
  • Fax:
Mailing address:
  • Phone: 347-485-0656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number740539-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: