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NPI Code Detail

MEDICARE: OLIVIA C ANAELE-NWOGU NURSE PRACTITIONER

MEDICARE: OLIVIA C ANAELE-NWOGU NURSE PRACTITIONER
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
1363LA2200XAdult Health Nurse PractitionerR195045MD
2363LG0600XGerontology Nurse PractitionerR195045MD
3363LP2300XPrimary Care Nurse PractitionerR195045MD
4363LP0808XPsychiatric/Mental Health Nurse PractitionerR195045MD

General Provider Information

NPI Number : 1710408885
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA C ANAELE-NWOGU NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 4622 DR BEANS LEGACY CIR
Second Line :
City : BOWIE
State : MD
Zip : 20720-6386
Country : US
Telephone Number : 301-356-3548
Fax Number :
Provider Business Practice Location Address
First Line : 9211 STUART LN
Second Line :
City : CLINTON
State : MD
Zip : 20735-2712
Country : US
Telephone Number : 301-868-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2017
Last Update Date : 01/27/2025

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Directions to “ OLIVIA C ANAELE-NWOGU NURSE PRACTITIONER” Practice Location

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