Healthcare Provider Details

I. General information

NPI: 1396693677
Provider Name (Legal Business Name): PEACEMAKER NWAMAKA MGBOJI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 OAK VALLEY DR
BEL AIR MD
21014-5941
US

IV. Provider business mailing address

214 OAK VALLEY DR
BEL AIR MD
21014-5941
US

V. Phone/Fax

Practice location:
  • Phone: 410-318-9167
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR128764
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR128764
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: