=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972494953
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ONYEACHU FAMILY NURSE PRACTITIONER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/09/2025
-----------------------------------------------------
Last Update Date | 07/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 85 N LANSDOWNE AVE STE 6
-----------------------------------------------------
City | LANSDOWNE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19050-2073
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-519-7794
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 85 N LANSDOWNE AVE STE 6
-----------------------------------------------------
City | LANSDOWNE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19050-2073
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-519-7794
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER OF ENTITY
-----------------------------------------------------
Name | HARRIET A ONYEACHU
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 215-519-7794
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------