Provider Demographics
NPI:1962041855
Name:UZOMA, VIVIAN (DNP, CRNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:
Last Name:UZOMA
Suffix:
Gender:F
Credentials:DNP, CRNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 E NORTHERN PKWY STE 208
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2110
Mailing Address - Country:US
Mailing Address - Phone:410-864-1800
Mailing Address - Fax:410-864-1717
Practice Address - Street 1:1900 E NORTHERN PKWY STE 208
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2110
Practice Address - Country:US
Practice Address - Phone:410-864-1800
Practice Address - Fax:410-864-1717
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR185036363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily