Provider Demographics
NPI:1720705585
Name:NWEKE, JANEMAUREEN NNEKA
Entity Type:Individual
Prefix:MRS
First Name:JANEMAUREEN
Middle Name:NNEKA
Last Name:NWEKE
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 1:3025 TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-6405
Mailing Address - Country:US
Mailing Address - Phone:410-209-0616
Mailing Address - Fax:
Practice Address - Street 1:3025 TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-6405
Practice Address - Country:US
Practice Address - Phone:410-209-0616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR13844363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health