Provider Demographics
NPI:1063831212
Name:UGWANYI, CHINYERE (CRNP, PMHNP)
Entity type:Individual
Prefix:
First Name:CHINYERE
Middle Name:
Last Name:UGWANYI
Suffix:
Gender:F
Credentials:CRNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 BUCKEYSTOWN PIKE STE 250
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-8344
Mailing Address - Country:US
Mailing Address - Phone:301-263-7441
Mailing Address - Fax:443-558-3779
Practice Address - Street 1:5100 BUCKEYSTOWN PIKE STE 250
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-8344
Practice Address - Country:US
Practice Address - Phone:301-637-4412
Practice Address - Fax:443-558-3779
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027889363LP0808X
OHCOA.15582-NP363LP0808X
MDR237702363LP0808X
VA0024175875363LP0808X
PASP029327363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health