Provider Demographics
NPI:1871005462
Name:CHUKWUJIOKE, LEONARD I
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:I
Last Name:CHUKWUJIOKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-3337
Mailing Address - Country:US
Mailing Address - Phone:800-601-0790
Mailing Address - Fax:571-441-0861
Practice Address - Street 1:316 WARREN AVE STE 2
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-4480
Practice Address - Country:US
Practice Address - Phone:804-588-9178
Practice Address - Fax:571-441-0861
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAB509848374T00000X, 376J00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1114441094Medicaid
VA1114441094OtherANTHEM