MEDICARE: DR. CHIAMAKA ADAKU NNAH RN, PMHNP-BC, DNP

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	163WP0807X	Child & Adolescent Psychiatric/Mental Health Registered Nurse	R239396	MD
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R239396	MD
3	163W00000X	Registered Nurse	R239396	MD
4	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	R239396	MD

General Provider Information

NPI Number	:	1205587284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHIAMAKA ADAKU NNAH RN, PMHNP-BC, DNP

Provider Business Mailing Address
First Line	:	3220 RIDGEWAY PL
Second Line	:
City	:	WINDSOR MILL
State	:	MD
Zip	:	21244-1021
Country	:	US
Telephone Number	:	443-857-5355
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 FREDERICK RD STE 11
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-4607
Country	:	US
Telephone Number	:	443-468-4838
Fax Number	:	410-231-6333

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

Provider Enumeration Date	:	01/12/2022
Last Update Date	:	12/02/2025

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