Provider Demographics
NPI:1538796008
Name:O'HARA, CHINWE CHRISTIANA (NP-C)
Entity type:Individual
Prefix:
First Name:CHINWE
Middle Name:CHRISTIANA
Last Name:O'HARA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3079 HIDDEN FOREST CT UNIT 3650
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3137
Mailing Address - Country:US
Mailing Address - Phone:404-408-3637
Mailing Address - Fax:
Practice Address - Street 1:3079 HIDDEN FOREST CT UNIT 3650
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-3137
Practice Address - Country:US
Practice Address - Phone:404-408-3637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-25
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN193764363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily