Healthcare Provider Details

I. General information

NPI: 1740199470
Provider Name (Legal Business Name): KELECHI ALOZIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

12410 MADELEY LN
BOWIE MD
20715-2903
US

IV. Provider business mailing address

12410 MADELEY LN
BOWIE MD
20715-2903
US

V. Phone/Fax

Practice location:
  • Phone: 240-467-6463
  • Fax:
Mailing address:
  • Phone: 240-467-6463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR252519
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: