Provider Demographics
NPI:1528549219
Name:OGBOLU, CHIKA I (NP)
Entity type:Individual
Prefix:
First Name:CHIKA
Middle Name:I
Last Name:OGBOLU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHIKA
Other - Middle Name:I
Other - Last Name:UMEJEI OGBOLU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:721 REDLEAFE CIR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3226
Mailing Address - Country:US
Mailing Address - Phone:757-209-4607
Mailing Address - Fax:757-300-5724
Practice Address - Street 1:425 W WASHINGTON ST STE 4
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5320
Practice Address - Country:US
Practice Address - Phone:575-209-4607
Practice Address - Fax:757-300-5724
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176503363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health