Provider Demographics
NPI:1164012795
Name:UZOMA, CHIOMA CALISTA (PMHNP - BC)
Entity Type:Individual
Prefix:
First Name:CHIOMA
Middle Name:CALISTA
Last Name:UZOMA
Suffix:
Gender:F
Credentials:PMHNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3732 SENECA GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-7517
Mailing Address - Country:US
Mailing Address - Phone:443-743-5998
Mailing Address - Fax:
Practice Address - Street 1:4002 W BELVEDERE AVE UNIT A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5502
Practice Address - Country:US
Practice Address - Phone:443-743-5998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR221556163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health