Provider Demographics
NPI:1578056602
Name:NWANERI, CHIOMA THERESA
Entity Type:Individual
Prefix:
First Name:CHIOMA
Middle Name:THERESA
Last Name:NWANERI
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 1:1516 NOVEMBER CIR APT 201
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6943
Mailing Address - Country:US
Mailing Address - Phone:240-762-9343
Mailing Address - Fax:
Practice Address - Street 1:1516 NOVEMBER CIR APT 201
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904
Practice Address - Country:US
Practice Address - Phone:240-762-9343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13811374U00000X
DCNA0000607349376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCNA0000607349OtherCERTIFIED NURSING ASSISTANT