Provider Demographics
NPI:1376275222
Name:CHUKWU, CHINENYE LOVETH (PMHNP)
Entity Type:Individual
Prefix:
First Name:CHINENYE
Middle Name:LOVETH
Last Name:CHUKWU
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 ALLANS MILL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-4269
Mailing Address - Country:US
Mailing Address - Phone:803-528-2497
Mailing Address - Fax:
Practice Address - Street 1:304 ALLANS MILL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-4269
Practice Address - Country:US
Practice Address - Phone:803-528-2497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26128363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health