Healthcare Provider Details

I. General information

NPI: 1598418048
Provider Name (Legal Business Name): OCALMHEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7420 ROSSVILLE BLVD
ROSEDALE MD
21237-3714
US

IV. Provider business mailing address

7420 ROSSVILLE BLVD
ROSEDALE MD
21237-3714
US

V. Phone/Fax

Practice location:
  • Phone: 443-469-2850
  • Fax: 443-595-9706
Mailing address:
  • Phone: 443-469-2850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: OROGBUO JUNIOR CHUKU
Title or Position: NURSE PRACTITIONER
Credential:
Phone: 443-469-2850