Healthcare Provider Details

I. General information

NPI: 1437413820
Provider Name (Legal Business Name): CHINENYE ANTHONIA OSUORJI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHINENYE ANTHONIA OKPARA MD

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 NORTHRISE DR
LAS CRUCES NM
88011-7327
US

IV. Provider business mailing address

4050 NORTHRISE DR
LAS CRUCES NM
88011-7327
US

V. Phone/Fax

Practice location:
  • Phone: 575-222-4323
  • Fax:
Mailing address:
  • Phone: 575-652-3040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD2015-0625
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0625
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberV4455
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: