Provider Demographics
NPI:1356021679
Name:CHUKWU, ESTHER OLUCHUKWU
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:OLUCHUKWU
Last Name:CHUKWU
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 1:611 CHURCH ST N
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-4322
Mailing Address - Country:US
Mailing Address - Phone:704-963-9270
Mailing Address - Fax:704-963-9038
Practice Address - Street 1:611 CHURCH ST N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4322
Practice Address - Country:US
Practice Address - Phone:704-963-9270
Practice Address - Fax:704-963-9038
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC005590363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health