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General NPI Number Information
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NPI Number | 1508141383
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Entity Type | Individual
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Provider Name | OLUCHI JOSEPHINE AYICHI
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Gender | Female
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Dates
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Enumeration Date | 10/12/2011
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 826 WASHINGTON RD SUITE 110A
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City | WESTMINSTER
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State | MD
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Zip | 21157-5750
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Country | US
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Telephone | 410-751-7480
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 MARGLENN AVE
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City | BALTIMORE
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State | MD
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Zip | 21206-2036
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Country | US
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Telephone | 410-350-6187
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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 | R156119
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License Number State | MD
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