Provider Demographics
NPI:1710682059
Name:NKWONTA, CHINELO (DOULA)
Entity Type:Individual
Prefix:
First Name:CHINELO
Middle Name:
Last Name:NKWONTA
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6809 SE DREW ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97222-1834
Mailing Address - Country:US
Mailing Address - Phone:971-330-9821
Mailing Address - Fax:
Practice Address - Street 1:6809 SE DREW ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97222-1834
Practice Address - Country:US
Practice Address - Phone:971-330-9821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula