Healthcare Provider Details

I. General information

NPI: 1265195853
Provider Name (Legal Business Name): CHIBUGO UWAZIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2021
Last Update Date: 10/20/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5230 TOWERS TER STE 538
PITTSBURGH PA
15229-2231
US

IV. Provider business mailing address

705 GARDEN CITY DR
MONROEVILLE PA
15146-1115
US

V. Phone/Fax

Practice location:
  • Phone: 412-864-7706
  • Fax:
Mailing address:
  • Phone: 412-260-3704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSPO24569
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: