Provider Demographics
NPI:1952056715
Name:ONWUMELU, NGOZI M (CRNP)
Entity type:Individual
Prefix:
First Name:NGOZI
Middle Name:M
Last Name:ONWUMELU
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3806 ANGELTON CT
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-2060
Mailing Address - Country:US
Mailing Address - Phone:301-338-1032
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE BLDG 193
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5477
Practice Address - Country:US
Practice Address - Phone:301-319-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-19
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR211356163WC0400X, 171M00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No171M00000XOther Service ProvidersCase Manager/Care Coordinator