Provider Demographics
NPI:1275224651
Name:CHUKWU, PATRICIA UCHENNA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:UCHENNA
Last Name:CHUKWU
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 1:1733 AMARYLLIS CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825
Mailing Address - Country:US
Mailing Address - Phone:407-466-7752
Mailing Address - Fax:
Practice Address - Street 1:2400 MAITLAND CENTER PKWY STE 310
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7442
Practice Address - Country:US
Practice Address - Phone:407-426-4800
Practice Address - Fax:407-426-4820
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11026169363L00000X
FL11026169363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner