Provider Demographics
NPI:1437827862
Name:UZOUKWU, THERESA AMAKA (CRNP-PMP)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:AMAKA
Last Name:UZOUKWU
Suffix:
Gender:F
Credentials:CRNP-PMP
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:AMAKA
Other - Last Name:UZOUKWU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3404 SPECTACULAR BID CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1284
Mailing Address - Country:US
Mailing Address - Phone:240-505-5021
Mailing Address - Fax:
Practice Address - Street 1:3404 SPECTACULAR BID CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1284
Practice Address - Country:US
Practice Address - Phone:240-505-5021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR212243363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health