Healthcare Provider Details

I. General information

NPI: 1871005462
Provider Name (Legal Business Name): LEONARD I CHUKWUJIOKE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2017
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 BLUE RIDGE AVE
FRONT ROYAL VA
22630-3005
US

IV. Provider business mailing address

303 BLUE RIDGE AVE
FRONT ROYAL VA
22630-3005
US

V. Phone/Fax

Practice location:
  • Phone: 703-930-9210
  • Fax: 540-930-1484
Mailing address:
  • Phone: 703-930-9210
  • Fax: 540-930-1484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374T00000X
TaxonomyReligious Nonmedical Nursing Personnel
License NumberB509848
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberB509848
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberB509848
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberHCO-0001833
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: