Provider Demographics
NPI:1831718030
Name:NWANAJUOBI, ONYINYECHI JENNIFER (NP)
Entity type:Individual
Prefix:
First Name:ONYINYECHI
Middle Name:JENNIFER
Last Name:NWANAJUOBI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:NWANAJUOBI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:333 N SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:800-427-1902
Mailing Address - Fax:800-564-5952
Practice Address - Street 1:12304 BALTIMORE AVE STE A
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1314
Practice Address - Country:US
Practice Address - Phone:240-264-1692
Practice Address - Fax:240-264-1696
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN176825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily