Provider Demographics
NPI:1184089021
Name:CHIGBU, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CHIGBU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5229 KENILWORTH AVE
Mailing Address - Street 2:APT. 101
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-2852
Mailing Address - Country:US
Mailing Address - Phone:202-320-6780
Mailing Address - Fax:
Practice Address - Street 1:5229 KENILWORTH AVE
Practice Address - Street 2:APT. 101
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781-2852
Practice Address - Country:US
Practice Address - Phone:202-320-6780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1004499164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse