Provider Demographics
NPI:1891232005
Name:OBIUKWU, CHIOMA GENEVIEVE (NP)
Entity Type:Individual
Prefix:DR
First Name:CHIOMA
Middle Name:GENEVIEVE
Last Name:OBIUKWU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 KUSER RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3828
Mailing Address - Country:US
Mailing Address - Phone:609-585-0022
Mailing Address - Fax:609-585-0221
Practice Address - Street 1:1540 KUSER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3828
Practice Address - Country:US
Practice Address - Phone:609-585-0022
Practice Address - Fax:609-585-0221
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-25
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00699900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health