Provider Demographics
NPI:1518710250
Name:NWOSU, ANDERLINE NNEKA
Entity Type:Individual
Prefix:
First Name:ANDERLINE
Middle Name:NNEKA
Last Name:NWOSU
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 1:3510 TOLLY PL
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2560
Mailing Address - Country:US
Mailing Address - Phone:240-636-2170
Mailing Address - Fax:
Practice Address - Street 1:3510 TOLLY PL
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:MD
Practice Address - Zip Code:20774-2560
Practice Address - Country:US
Practice Address - Phone:240-636-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR211336163W00000X
DCRN1010362163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse