Provider Demographics
NPI:1497100168
Name:UMEKWE, OLUCHI
Entity Type:Individual
Prefix:
First Name:OLUCHI
Middle Name:
Last Name:UMEKWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 MERGANSER CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-7043
Mailing Address - Country:US
Mailing Address - Phone:301-523-5825
Mailing Address - Fax:
Practice Address - Street 1:1001 MERGANSER CT
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-7043
Practice Address - Country:US
Practice Address - Phone:301-523-5825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1004878164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse