Provider Demographics
NPI:1497358642
Name:ONU, NJIDEKA U (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:NJIDEKA
Middle Name:U
Last Name:ONU
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4212
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22194-4212
Mailing Address - Country:US
Mailing Address - Phone:571-481-2442
Mailing Address - Fax:703-619-5283
Practice Address - Street 1:46090 LAKE CENTER PLZ STE 201
Practice Address - Street 2:
Practice Address - City:POTOMAC FALLS
Practice Address - State:VA
Practice Address - Zip Code:20165-5878
Practice Address - Country:US
Practice Address - Phone:240-486-6516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2020092490363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner