Healthcare Provider Details

I. General information

NPI: 1942405063
Provider Name (Legal Business Name): ASSUMPTA N NWACHUKWU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 COUNTY HOUSE RD
SEWELL NJ
08080-2525
US

IV. Provider business mailing address

211 COUNTY HOUSE RD
SEWELL NJ
08080-2525
US

V. Phone/Fax

Practice location:
  • Phone: 877-823-5230
  • Fax: 215-823-5265
Mailing address:
  • Phone: 877-823-5230
  • Fax: 215-823-5265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00129500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number26NJ00129500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: