MEDICARE: CHINYERE CHIKODI OHALETE

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	R124243	MD

General Provider Information

NPI Number	:	1629910807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHINYERE CHIKODI OHALETE

Provider Business Mailing Address
First Line	:	110 IRVING ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-3017
Country	:	US
Telephone Number	:	202-877-0732
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 SUTTON CT
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-1424
Country	:	US
Telephone Number	:	301-385-8122
Fax Number	:

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

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “ CHINYERE CHIKODI OHALETE ” Practice Location

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