Evangeline Uju Okechukwu, CRNP-PMH

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R146100 Issued in MD

Practice address

111 Warren Rd Ste 10a
Cockeysville, MD 21030-2452

Phone

(443) 345-0356

NPI assigned

Feb 13, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Evangeline Uju Ohanagorom Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Barbara a Bradshaw, LCPC, LLC

  • Community/Behavioral Health Agency
  • Cockeysville, MD
  • NPI 1477324911
  NPD

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696636800000",
    "number": "1972200624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WARREN RD STE 10A",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210302452",
            "telephone_number": "443-345-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WARREN RD STE 10A",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210302452",
            "telephone_number": "443-345-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKECHUKWU",
        "first_name": "EVANGELINE",
        "middle_name": "UJU",
        "name_prefix": "Dr.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-10-07",
        "certification_date": "2023-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R146100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVANGELINE",
            "last_name": "OHANAGOROM",
            "middle_name": "UJU",
            "prefix": "MS.",
            "credential": "N/A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Omnibus Health, LLC.
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• Omosigho Osian, PHARMD
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• Psychiatric/Mental Health Nurse Practitioner in Cockeysville, MD
• Providers in Cockeysville, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2023; 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.