MEDICARE: TOBECHUKWU PRINCETON ONYIRIUKA FNP-C

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	363LF0000X	Family Nurse Practitioner	5016445	NC
2	363LF0000X	Family Nurse Practitioner	11020144	FL

General Provider Information

NPI Number	:	1376272716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOBECHUKWU PRINCETON ONYIRIUKA FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 1253
Second Line	:
City	:	MOORESVILLE
State	:	NC
Zip	:	28115-1253
Country	:	US
Telephone Number	:	980-483-4400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4111 ROSE LAKE DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-2829
Country	:	US
Telephone Number	:	704-807-0914
Fax Number	:

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

Provider Enumeration Date	:	06/09/2022
Last Update Date	:	09/19/2025

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