Doctor Name: | CHINELO ASIKE |
NPI Number: | 1073960852 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | R200538 |
Business Practice Address: | 9055 Chevrolet Dr #103 Ellicott City, MD - 210424016 |
Business Phone Number: | 4104657850 |
Business Fax Number: | |
Mailing Address: | 9055 Chevrolet Dr, #103 ELLICOTT CITY |
State: | MD |
Postal Code: | 210424016 |
Phone Number: | 4104657850 |
Fax Number: | |
NPI Enumeration Date: | 05/20/2016 |
NPI Last Update Date: | 06/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R200538 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |