Provider Demographics
NPI:1255844395
Name:ODENIGBO, NONYELUM PATIENCE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:NONYELUM
Middle Name:PATIENCE
Last Name:ODENIGBO
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 1:6815 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3639
Mailing Address - Country:US
Mailing Address - Phone:301-257-4153
Mailing Address - Fax:
Practice Address - Street 1:6815 99TH AVE
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3639
Practice Address - Country:US
Practice Address - Phone:130-125-7415
Practice Address - Fax:301-257-4153
Is Sole Proprietor?:No
Enumeration Date:2017-11-12
Last Update Date:2017-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR191666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily