Provider Demographics
NPI:1275234809
Name:NWUCHU, VIVIAN NKECHI (FNP-BC)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:NKECHI
Last Name:NWUCHU
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6882 ARCHIBALD DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8465
Mailing Address - Country:US
Mailing Address - Phone:202-378-0512
Mailing Address - Fax:
Practice Address - Street 1:6882 ARCHIBALD DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-8465
Practice Address - Country:US
Practice Address - Phone:202-378-0512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2022096960363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily