Provider Demographics
NPI:1184323511
Name:CHIEDU, ESTHER
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:CHIEDU
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 1:9801 GREENBELT RD STE 318
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-6231
Mailing Address - Country:US
Mailing Address - Phone:443-562-0480
Mailing Address - Fax:
Practice Address - Street 1:2901 DRUID PARK DR STE A202
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-8131
Practice Address - Country:US
Practice Address - Phone:443-540-0338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-24
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR235421363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health