Healthcare Provider Details

I. General information

NPI: 1700226875
Provider Name (Legal Business Name): CHINWE P OHAKA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2013
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2251 N SQUIRREL RD STE 315-320
AUBURN HILLS MI
48326-4600
US

IV. Provider business mailing address

1560 E MAPLE ROAD SUITE 400 - CREDENTIALING DEPARTMENT
TROY MI
48083-1138
US

V. Phone/Fax

Practice location:
  • Phone: 517-492-0784
  • Fax:
Mailing address:
  • Phone: 313-745-4275
  • Fax: 313-745-4468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704269173
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704269173
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704269173
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: