Provider Demographics
NPI:1144908245
Name:ONWUNMELU, NNENNA (RN)
Entity type:Individual
Prefix:
First Name:NNENNA
Middle Name:
Last Name:ONWUNMELU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15000 POTOMAC TOWN PL STE 100-150
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-6586
Mailing Address - Country:US
Mailing Address - Phone:727-266-3662
Mailing Address - Fax:703-997-0073
Practice Address - Street 1:3596 BRIARWOOD DR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-6202
Practice Address - Country:US
Practice Address - Phone:703-997-0967
Practice Address - Fax:703-997-0073
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041389695163W00000X
VA0001264875163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse