Provider Demographics
NPI:1285341230
Name:OBI, CHIKODILI FAITH (PMHNP)
Entity type:Individual
Prefix:
First Name:CHIKODILI
Middle Name:FAITH
Last Name:OBI
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S HENDERSON RD STE 150
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4234
Mailing Address - Country:US
Mailing Address - Phone:267-416-0808
Mailing Address - Fax:380-203-1333
Practice Address - Street 1:601 S HENDERSON RD STE 150
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4234
Practice Address - Country:US
Practice Address - Phone:267-416-0808
Practice Address - Fax:380-203-1333
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026404363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP026404OtherPMHNP LICENSE