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General NPI Number Information
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NPI Number | 1760127401
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Entity Type | Individual
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Provider Name | CHIDIEBUBE PRINCESS NZEAKO
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Gender | Female
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Dates
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Enumeration Date | 04/27/2022
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 2041 GEORGIA AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20060-0002
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Country | US
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Telephone | 202-865-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 410-933-0000
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0101669
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License Number State | MD
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