Provider Demographics
NPI:1427396373
Name:CHIEKWU, NGOZI THERESA (PMHNP)
Entity Type:Individual
Prefix:
First Name:NGOZI
Middle Name:THERESA
Last Name:CHIEKWU
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:NGOZI
Other - Last Name:CHIEKWU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:1508 PENNSYLVANIA AVE STE 1C
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-4347
Mailing Address - Country:US
Mailing Address - Phone:302-427-8000
Mailing Address - Fax:302-601-5583
Practice Address - Street 1:1508 PENNSYLVANIA AVE STE 1C
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-4347
Practice Address - Country:US
Practice Address - Phone:302-427-8000
Practice Address - Fax:302-601-5583
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2012015244163WP0808X
DEL-80000157363LP0808X
MDAC001249363LP0808X
DEL8-0000157363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000000OtherDONT HAVE ONE