Provider Demographics
NPI:1164533469
Name:ACHI, CHINYERE PRISCY (CRNP)
Entity Type:Individual
Prefix:
First Name:CHINYERE
Middle Name:PRISCY
Last Name:ACHI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 NANDINA ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-3245
Mailing Address - Country:US
Mailing Address - Phone:215-673-7991
Mailing Address - Fax:215-673-8087
Practice Address - Street 1:3900 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4551
Practice Address - Country:US
Practice Address - Phone:215-823-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP003934C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2094468OtherHIGHMARK BLUE SHIELD
PAP00766570OtherRR MEDICARE
PA2094468OtherHIGHMARK BLUE SHIELD
PA018762ZDKTMedicare PIN