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NPI Code Detail

MEDICARE: ELIZABETH ODUKOYA

MEDICARE:   ELIZABETH  ODUKOYA
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
1164W00000XLicensed Practical NurseLPN 7665DC

General Provider Information

NPI Number : 1649530288
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ODUKOYA
Provider Business Mailing Address
First Line : 6400 OLD CHAPEL TERRACE
Second Line :
City : BOWIE
State : MD
Zip : 20720
Country : US
Telephone Number : 301-755-3392
Fax Number :
Provider Business Practice Location Address
First Line : 6400 OLD CHAPEL TER
Second Line : 228
City : BOWIE
State : MD
Zip : 20720-4609
Country : US
Telephone Number : 301-755-3392
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2012
Last Update Date : 06/20/2014

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Directions to “ ELIZABETH ODUKOYA ” Practice Location

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