Active NPI
Nwanne Udeagha
- Pharmacist
- Woodbine, MD
National Provider Identifier
1104046960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16399
- Practice address
- 14709 Susan Marie Way
Woodbine, MD 21797-8617 - Phone
- (202) 615-9100
- NPI assigned
- Apr 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16399 | MD | Primary |
Addresses
Primary practice location
14709 Susan Marie Way
Woodbine, MD 21797-8617
Mailing address
14709 Susan Marie Way
Woodbine, MD 21797-8617
Phone (202) 615-9100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16399 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifelong Support Inc | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- In Home Supportive Care Agency
- Woodbine, MD
- NPI 1366302820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759104000000",
"number": "1104046960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14709 SUSAN MARIE WAY",
"city": "WOODBINE",
"state": "MD",
"postal_code": "217978617",
"telephone_number": "202-615-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14709 SUSAN MARIE WAY",
"city": "WOODBINE",
"state": "MD",
"postal_code": "217978617",
"telephone_number": "202-615-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDEAGHA",
"first_name": "NWANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2025-09-29",
"certification_date": "2025-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "16399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbine, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.