Provider Demographics
NPI:1275135386
Name:NWANKWO, CHIJIOKE ERNIE (DNP, CRNP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CHIJIOKE
Middle Name:ERNIE
Last Name:NWANKWO
Suffix:
Gender:M
Credentials:DNP, CRNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5622
Mailing Address - Country:US
Mailing Address - Phone:484-973-6661
Mailing Address - Fax:610-323-6058
Practice Address - Street 1:404 E HIGH ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5622
Practice Address - Country:US
Practice Address - Phone:484-973-6661
Practice Address - Fax:610-323-6058
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022350363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health