MEDICARE: NKECHI OKORO NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	R153973	MD
2	363LA2100X	Acute Care Nurse Practitioner	R153973	MD

General Provider Information

NPI Number	:	1093540064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NKECHI OKORO NP

Provider Business Mailing Address
First Line	:	1738 PLEASANTVILLE RD
Second Line	:
City	:	FOREST HILL
State	:	MD
Zip	:	21050-2308
Country	:	US
Telephone Number	:	443-326-3862
Fax Number	:

Provider Business Practice Location Address
First Line	:	1738 PLEASANTVILLE RD
Second Line	:
City	:	FOREST HILL
State	:	MD
Zip	:	21050-2308
Country	:	US
Telephone Number	:	443-326-3862
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2024
Last Update Date	:	09/07/2024

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