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General NPI Number Information
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NPI Number | 1710600358
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Entity Type | Organization
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Legal Business Name | KEVIN O ONUEKWUSI
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 3311 TOLEDO TER STE B204
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City | HYATTSVILLE
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State | MD
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Zip | 20782-8149
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Country | US
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Telephone | 240-416-3684
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Fax |
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Provider Business Mailing Address
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Address Line | 3311 TOLEDO TER STE B204
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City | HYATTSVILLE
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State | MD
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Zip | 20782-8149
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Country | US
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Telephone | 240-416-3684
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Fax |
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Authorized Official
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Title or Position | OWNER OF ENTITY
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Name | KEVIN ONUEKWUSI
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Credential | DNP, CRNP, AGNP
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Telephone | 240-416-3684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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