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General NPI Number Information
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NPI Number | 1801335351
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Entity Type | Individual
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Provider Name | CHINENYE OGBONNA
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Gender | Female
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Dates
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Enumeration Date | 02/16/2017
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 786 D ST
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City | FORT RICHARDSON
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State | AK
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Zip | 99505-1023
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Country | US
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Telephone | 907-384-0405
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Fax |
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Provider Business Mailing Address
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Address Line | 4076 NEELY ROAD; BLDG 4076, ROOM 1B-201
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City | FORT WAINWRIGHT
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State | AK
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Zip | 99703
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Country | US
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Telephone | 907-361-4000
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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 | 4704317732
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License Number State | MI
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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 | 4704317732
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License Number State | MI
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