Provider Demographics
NPI:1013625623
Name:OSUAGWU, SCHOLARSTICA NKECHINYERE
Entity Type:Individual
Prefix:MRS
First Name:SCHOLARSTICA
Middle Name:NKECHINYERE
Last Name:OSUAGWU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 ELLEN CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1273
Mailing Address - Country:US
Mailing Address - Phone:301-789-8344
Mailing Address - Fax:
Practice Address - Street 1:3511 ELLEN CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1273
Practice Address - Country:US
Practice Address - Phone:301-789-8344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP1045930163WP0808X
MDR245764363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCNAMedicaid