Provider Demographics
NPI:1013631324
Name:UWAKWE, LINDA ESOSA (NP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ESOSA
Last Name:UWAKWE
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 1:5215 CORBIN CT
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-3396
Mailing Address - Country:US
Mailing Address - Phone:404-567-9442
Mailing Address - Fax:
Practice Address - Street 1:5215 CORBIN CT
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-3396
Practice Address - Country:US
Practice Address - Phone:404-567-9442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN168828363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health