Provider Demographics
NPI:1659960201
Name:CHIEDU, OROBOSA (NP)
Entity type:Individual
Prefix:
First Name:OROBOSA
Middle Name:
Last Name:CHIEDU
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 1:1917 PELHAM DR
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-4449
Mailing Address - Country:US
Mailing Address - Phone:617-955-4800
Mailing Address - Fax:
Practice Address - Street 1:222 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-2341
Practice Address - Country:US
Practice Address - Phone:617-955-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2349135363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health