Healthcare Provider Details

I. General information

NPI: 1730639535
Provider Name (Legal Business Name): CHINWE OKUDO CRNP DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5440 BELAIR RD
BALTIMORE MD
21206-4208
US

IV. Provider business mailing address

5440 BELAIR RD
BALTIMORE MD
21206-4208
US

V. Phone/Fax

Practice location:
  • Phone: 443-868-7405
  • Fax:
Mailing address:
  • Phone: 443-868-7405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR198702
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR193702
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: