Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Legacy Medical Clinic with Mental Health, LLC

Organization Family Nurse Practitioner · NPI 1174388771

Legacy Medical Clinic with Mental Health, LLC is a Family Nurse Practitioner in Temple Hills, Maryland. Works from 2 locations. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4700 Stamp Rd Ste K
Temple Hills, MD 20748-6717
Phone: (301) 880-4900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1203 West St, Annapolis, MD 21401-3662 — (410) 263-4366

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1174388771
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chuks Nwaulu — Owner · (240) 422-0687
NPI enumeratedFebruary 14, 2024
Last updated in NPPESFebruary 14, 2024
Certification dateFebruary 13, 2024
Mailing address9509 Manor Oaks Vw, Upper Marlboro, MD 20772-3192

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