Provider Demographics
NPI:1134819345
Name:NWORJI-AMAH, IFEYINWA VIOLA I (PMHNP)
Entity type:Individual
Prefix:
First Name:IFEYINWA
Middle Name:VIOLA
Last Name:NWORJI-AMAH
Suffix:I
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 1:7701 BIG BUCK DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2067
Mailing Address - Country:US
Mailing Address - Phone:410-212-9592
Mailing Address - Fax:
Practice Address - Street 1:20 CROSSROADS DR
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5419
Practice Address - Country:US
Practice Address - Phone:443-895-0898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR200279363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health