Provider Demographics
NPI:1568051696
Name:NWOKOCHA, NGOZI JULIANA
Entity Type:Individual
Prefix:MRS
First Name:NGOZI
Middle Name:JULIANA
Last Name:NWOKOCHA
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 1:5453 MADISON WAY APT 10
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1055
Mailing Address - Country:US
Mailing Address - Phone:240-825-7498
Mailing Address - Fax:
Practice Address - Street 1:5453 MADISON WAY APT 10
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1055
Practice Address - Country:US
Practice Address - Phone:240-825-7498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNA0000812122376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA00179867OtherGNA
DCNA0000812122OtherCNA