Healthcare Provider Details

I. General information

NPI: 1477881548
Provider Name (Legal Business Name): ALICE CHINYERE UKAEGBU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2009
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8120 FENTON ST STE 204
SILVER SPRING MD
20910-4753
US

IV. Provider business mailing address

7514 EASTERN AVE NW
WASHINGTON DC
20012-1822
US

V. Phone/Fax

Practice location:
  • Phone: 202-531-2607
  • Fax:
Mailing address:
  • Phone: 202-829-4269
  • Fax: 202-829-4269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN55058
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number867940
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ14865400
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024184379
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR102922
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: