Provider Demographics
NPI:1659985943
Name:OBI, ROSEMOURINE CHINWENDU (CRNP)
Entity Type:Individual
Prefix:MISS
First Name:ROSEMOURINE
Middle Name:CHINWENDU
Last Name:OBI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 VARNUM STREET NE. SUITE #218, WASHINGTON, DISTRICT
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON DC
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2324
Mailing Address - Country:US
Mailing Address - Phone:202-269-6600
Mailing Address - Fax:
Practice Address - Street 1:1160 VARNUM ST NE STE 218
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2106
Practice Address - Country:US
Practice Address - Phone:202-269-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1039612163WG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WG0600XNursing Service ProvidersRegistered NurseGerontology