MEDICARE: CHINYERE OBI

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	R185202	MD

General Provider Information

NPI Number	:	1568909620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHINYERE OBI

Provider Business Mailing Address
First Line	:	8508 LOCH RAVEN BLVD
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-2354
Country	:	US
Telephone Number	:	443-275-2357
Fax Number	:

Provider Business Practice Location Address
First Line	:	8508 LOCH RAVEN BLVD
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-2354
Country	:	US
Telephone Number	:	443-275-2357
Fax Number	:

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

Provider Enumeration Date	:	01/27/2017
Last Update Date	:	06/22/2023

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