MEDICARE: UZOAMAKA CHINATU EZEONU RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	RN294739	GA

General Provider Information

NPI Number	:	1154145472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UZOAMAKA CHINATU EZEONU RN

Provider Business Mailing Address
First Line	:	1090 TRIDENT MAPLE CHASE
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-6704
Country	:	US
Telephone Number	:	732-882-3338
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 GWINNETT DR
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30046-8444
Country	:	US
Telephone Number	:	678-209-2394
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2024
Last Update Date	:	01/27/2026

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