Provider Demographics
NPI:1881304905
Name:ONUORAH, NNEKA IMMACULATE
Entity type:Individual
Prefix:
First Name:NNEKA
Middle Name:IMMACULATE
Last Name:ONUORAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10312 GREENSIDE DR
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-3326
Mailing Address - Country:US
Mailing Address - Phone:443-813-1545
Mailing Address - Fax:
Practice Address - Street 1:720 BOSLEY AVE
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4011
Practice Address - Country:US
Practice Address - Phone:410-512-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR230665363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health