Individual
CHINWE IBIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
766 WALTHER RD STE 100, LAWRENCEVILLE, GA 30046-8765
(770) 736-6300
Mailing address
1885 SILVERSTONE DR, LAWRENCEVILLE, GA 30045-7273
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
RN217527
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN217527
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5012244
NC
Other
Enumeration date
07/28/2017
Last updated
05/07/2026
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