Provider Demographics
NPI:1134975618
Name:ALASORO, VINCENT UCHECHUKWU (FNP)
Entity type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:UCHECHUKWU
Last Name:ALASORO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 KENJAC RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-1323
Mailing Address - Country:US
Mailing Address - Phone:443-360-7900
Mailing Address - Fax:
Practice Address - Street 1:3301 KENJAC RD
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-1323
Practice Address - Country:US
Practice Address - Phone:443-360-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR237747363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily