MEDICARE: MRS. EVELYN CHINWE UWAKWE FNP

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	F337553-1	NY

General Provider Information

NPI Number	:	1578816344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EVELYN CHINWE UWAKWE FNP

Provider Business Mailing Address
First Line	:	1289 E 92ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4319
Country	:	US
Telephone Number	:	347-268-0523
Fax Number	:

Provider Business Practice Location Address
First Line	:	1289 E 92ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4319
Country	:	US
Telephone Number	:	347-268-0523
Fax Number	:

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

Provider Enumeration Date	:	10/18/2012
Last Update Date	:	10/18/2012

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