Healthcare Provider Details

I. General information

NPI: 1407113285
Provider Name (Legal Business Name): FRANCIS ACHANYILEKE PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 N CHARLES ST
BALTIMORE MD
21204-6819
US

IV. Provider business mailing address

849 FAIRMOUNT AVE FL 5
TOWSON MD
21286-2624
US

V. Phone/Fax

Practice location:
  • Phone: 410-938-3000
  • Fax:
Mailing address:
  • Phone: 443-377-5273
  • Fax: 443-659-2429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR224926
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR271581
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: