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NPI Code Detail

MEDICARE: NNEKA WOGU

MEDICARE: NNEKA WOGU
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerR210021MD

General Provider Information

NPI Number : 1215649686
Entity Type Code : Individual
Provider Name (Legal Business Name) : NNEKA WOGU
Provider Business Mailing Address
First Line : 12331 QUILT PATCH LN
Second Line :
City : BOWIE
State : MD
Zip : 20720-4358
Country : US
Telephone Number : 707-266-4997
Fax Number :
Provider Business Practice Location Address
First Line : 12530 FAIRWOOD PKWY STE 102
Second Line :
City : BOWIE
State : MD
Zip : 20720-6357
Country : US
Telephone Number : 301-900-5772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2022
Last Update Date : 02/02/2024

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Directions to “ NNEKA WOGU ” Practice Location

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