Princess Ujum Chukwuneke

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

9025 Issued in CT

Practice address

400 W Campus Dr
Orange, CT 06477-3646

Phone

(203) 785-2389

NPI assigned

Jun 8, 2020

Last updated

Jan 12, 2021By the provider in NPPES

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)

Enrolled

State licenses

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1932723764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 WINCHESTER AVE APT 1",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113502",
            "telephone_number": "516-943-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W CAMPUS DR",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773646",
            "telephone_number": "203-785-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUKWUNEKE",
        "first_name": "PRINCESS",
        "middle_name": "UJUM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "9025",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "153486",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Orange, CT
• Providers in Orange, CT by specialty
• Gerontology Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.