Healthcare Provider Details

I. General information

NPI: 1356167068
Provider Name (Legal Business Name): URELLA U NWABUEZE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2024
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6510 FRANKFORD AVE
BALTIMORE MD
21206-4906
US

IV. Provider business mailing address

6510 FRANKFORD AVE
BALTIMORE MD
21206-4906
US

V. Phone/Fax

Practice location:
  • Phone: 443-841-0999
  • Fax:
Mailing address:
  • Phone: 443-841-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN500005640
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR251049
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: