Provider Demographics
NPI:1861008070
Name:UCHENNA, AMARACHI C (RN)
Entity Type:Individual
Prefix:
First Name:AMARACHI
Middle Name:C
Last Name:UCHENNA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3686 S CENTINELA AVE APT 16
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-3150
Mailing Address - Country:US
Mailing Address - Phone:310-866-8391
Mailing Address - Fax:
Practice Address - Street 1:3686 S CENTINELA AVE APT 16
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-3150
Practice Address - Country:US
Practice Address - Phone:310-866-8391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95200769163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse