Healthcare Provider Details

I. General information

NPI: 1629776810
Provider Name (Legal Business Name): ROSETTA ONUH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4367 HOLLINS FERRY ROAD 1C 1C
BALTIMORE MD
21227-4677
US

IV. Provider business mailing address

13000 BELLE MEADE TRCE
BOWIE MD
20720-4677
US

V. Phone/Fax

Practice location:
  • Phone: 240-605-6112
  • Fax:
Mailing address:
  • Phone: 240-605-6112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR203457
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR203457
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR203457
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: