Provider Demographics
NPI:1851101828
Name:ARUA, NGOZI OLAMMA (RN, BSN, MSN, PMHNP)
Entity type:Individual
Prefix:
First Name:NGOZI
Middle Name:OLAMMA
Last Name:ARUA
Suffix:
Gender:F
Credentials:RN, BSN, MSN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 WAYLAND ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-3028
Mailing Address - Country:US
Mailing Address - Phone:857-260-0324
Mailing Address - Fax:
Practice Address - Street 1:117 WAYLAND ST
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-3028
Practice Address - Country:US
Practice Address - Phone:857-266-0324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2305366363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health