Provider Demographics
NPI:1700686946
Name:KINGDOM FIRST CARE
Entity type:Organization
Organization Name:KINGDOM FIRST CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHIBUGO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-326-7912
Mailing Address - Street 1:36 DRIFTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-3034
Mailing Address - Country:US
Mailing Address - Phone:443-326-7912
Mailing Address - Fax:
Practice Address - Street 1:36 DRIFTWOOD CT
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-3034
Practice Address - Country:US
Practice Address - Phone:443-326-7912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty