Individual
KELECHI NWOSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
895 BLUE HILL AVE, DORCHESTER, MA 02124-2902
(774) 360-7338
Mailing address
64 DONNA ST, BROCKTON, MA 02302-2458
(774) 360-7338
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2327773
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2327773
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S41108824
MASSGOV
MA
Enumeration date
03/07/2023
Last updated
08/30/2024
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