Provider Demographics
NPI:1649892738
Name:NWOSU, CHRISTOPHER OBIANOM
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:OBIANOM
Last Name:NWOSU
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 1:13603 SHALLOW WELL DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-7447
Mailing Address - Country:US
Mailing Address - Phone:704-918-2989
Mailing Address - Fax:
Practice Address - Street 1:11709 FRUEHAUF DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-7284
Practice Address - Country:US
Practice Address - Phone:704-918-2989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC5401374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide