MEDICARE: ALICE OFORI FNP

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	363LF0000X	Family Nurse Practitioner	R195947	MD

General Provider Information

NPI Number	:	1255044384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE OFORI FNP

Provider Business Mailing Address
First Line	:	3300 CENTENNIAL LN
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-3600
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 CENTENNIAL LN
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-3600
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

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

Provider Enumeration Date	:	01/04/2023
Last Update Date	:	03/31/2026

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