Healthcare Provider Details

I. General information

NPI: 1003329541
Provider Name (Legal Business Name): JULIET UGOCHI NWOKEDI PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 ENGLAR RD STE 10
WESTMINSTER MD
21157-2927
US

IV. Provider business mailing address

12425 DIPLOMA DR
REISTERSTOWN MD
21136-6040
US

V. Phone/Fax

Practice location:
  • Phone: 410-249-9612
  • Fax:
Mailing address:
  • Phone: 410-207-8691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR209732
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR209732
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: