Stacian Nwaukwa, DNP, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R178638 Issued in MD

Practice address

12 Brian Daniel CT
Reisterstown, MD 21136-4635

Phone

(410) 413-0376

NPI assigned

Nov 7, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: stacian.nwaukwa.p2@direct.clinicalassociates.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1437867728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BRIAN DANIEL CT",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211364635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BRIAN DANIEL CT",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211364635",
            "telephone_number": "410-413-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAUKWA",
        "first_name": "STACIAN",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R178638",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R178638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Linda Ngameduru
• Chelsea Norris, MS CCC SLP
• Juliet Lum Numfor
• Sandra Baah Nyarko, NP
• Joseph H. O'Leary, MD
• Alexander Obeahon
• Zachary Franklin Odani
• Michael Okojie, NURSE PRACTITIONER

• Adult Health Nurse Practitioner in Reisterstown, MD
• Providers in Reisterstown, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.