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General NPI Number Information
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NPI Number | 1164851572
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Entity Type | Individual
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Provider Name | CHARITY IFELUNWA NWOSA FNP-C APRN
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Gender | Female
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Dates
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Enumeration Date | 11/06/2013
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 6675 BUSINESS PKWY STE F
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City | ELKRIDGE
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State | MD
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Zip | 21075-6349
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Country | US
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Telephone | 866-799-5886
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Fax |
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Provider Business Mailing Address
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Address Line | 25342 WESTERN SAGE LN
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City | RICHMOND
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State | TX
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Zip | 77406-7877
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Country | US
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Telephone | 832-343-1619
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 804496
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1011383
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License Number State | TX
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