Healthcare Provider Details

I. General information

NPI: 1841560125
Provider Name (Legal Business Name): JOSEPHINE CHIEDU UKADILONU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2012
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16701 MELFORD BLVD STE 400
BOWIE MD
20715-4411
US

IV. Provider business mailing address

4806 BRIERCREST CT
BOWIE MD
20720-4839
US

V. Phone/Fax

Practice location:
  • Phone: 240-360-0290
  • Fax:
Mailing address:
  • Phone: 202-509-7160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF05240015
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: