MEDICARE: ALEXANDER UGWUNNA UKAOMA 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	0024175423	VA
2	363LF0000X	Family Nurse Practitioner	R214942	MD
3	363LF0000X	Family Nurse Practitioner	RN1018157	DC

General Provider Information

NPI Number	:	1982060083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER UGWUNNA UKAOMA FNP

Provider Business Mailing Address
First Line	:	6218 N KINGS HWY STE B
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22303-2442
Country	:	US
Telephone Number	:	571-560-2621
Fax Number	:	571-560-2622

Provider Business Practice Location Address
First Line	:	6218 N KINGS HWY STE B
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22303-2442
Country	:	US
Telephone Number	:	571-560-2621
Fax Number	:	571-560-2622

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

Provider Enumeration Date	:	01/06/2016
Last Update Date	:	04/07/2026

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