Provider Demographics
NPI:1225414147
Name:UDUHIRI, CHINYERE LESLIE (NP-C)
Entity Type:Individual
Prefix:
First Name:CHINYERE
Middle Name:LESLIE
Last Name:UDUHIRI
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9966 ROYAL COMMERCE PL
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1163
Mailing Address - Country:US
Mailing Address - Phone:240-646-2811
Mailing Address - Fax:
Practice Address - Street 1:9470 ANNAPOLIS RD
Practice Address - Street 2:STE 401
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3025
Practice Address - Country:US
Practice Address - Phone:240-646-2811
Practice Address - Fax:531-202-3274
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR134975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily