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General NPI Number Information
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NPI Number | 1023585676
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Entity Type | Individual
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Provider Name | CLARA IFEOMA ONYEIWU NP-FAMILY
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Gender | Female
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Dates
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Enumeration Date | 10/31/2018
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | KRYSTAL MEDICAL ASSOCIATES, 12150 ANNAPOLIS RD SUITE 100
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City | GLENNDALE
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State | MD
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Zip | 20769
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Country | US
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Telephone | 301-464-7601
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Fax |
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Provider Business Mailing Address
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Address Line | 5301 PATTINGHAM CT
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-2990
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Country | US
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Telephone | 301-464-7601
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R142679
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R142679
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License Number State | MD
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