Provider Demographics
NPI:1912538901
Name:NWOKOCHA, CHINENYE (NP-C)
Entity Type:Individual
Prefix:
First Name:CHINENYE
Middle Name:
Last Name:NWOKOCHA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 BEYERS LANDING DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-7180
Mailing Address - Country:US
Mailing Address - Phone:404-643-8767
Mailing Address - Fax:
Practice Address - Street 1:2000 BEYERS LANDING DR
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-7180
Practice Address - Country:US
Practice Address - Phone:404-643-8767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN217114363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily