Provider Demographics
NPI:1922567114
Name:NWACHUKWU, CHIOMA (RN, PHCNS)
Entity Type:Individual
Prefix:DR
First Name:CHIOMA
Middle Name:
Last Name:NWACHUKWU
Suffix:
Gender:F
Credentials:RN, PHCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3714 17TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2306
Mailing Address - Country:US
Mailing Address - Phone:202-291-5556
Mailing Address - Fax:
Practice Address - Street 1:3714 17TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2306
Practice Address - Country:US
Practice Address - Phone:202-291-5556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2021-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN66832163WC1500X, 364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public HealthGroup - Multi-Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty