Provider Demographics
NPI:1568238459
Name:OBINWANKWO, RICHARD EMMANUEL (NP)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:EMMANUEL
Last Name:OBINWANKWO
Suffix:
Gender:M
Credentials:NP
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:EMMANUEL
Other - Last Name:OBINWANKWO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:305 NORWALK WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8370
Mailing Address - Country:US
Mailing Address - Phone:267-475-2903
Mailing Address - Fax:
Practice Address - Street 1:305 NORWALK WAY
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-8370
Practice Address - Country:US
Practice Address - Phone:267-475-2903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0012548363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily