MEDICARE: ONYINYECHUKWU OKOLI APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024196286	VA

General Provider Information

NPI Number	:	1255286548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ONYINYECHUKWU OKOLI APRN

Provider Business Mailing Address
First Line	:	12005 ALMER LN
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23836-3081
Country	:	US
Telephone Number	:	567-377-0508
Fax Number	:	804-509-0542

Provider Business Practice Location Address
First Line	:	12005 ALMER LN
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23836-3081
Country	:	US
Telephone Number	:	567-377-0508
Fax Number	:	804-509-0542

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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