Healthcare Provider Details

I. General information

NPI: 1083405518
Provider Name (Legal Business Name): JOSEPH OKWOSHA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 K ST NW STE 1000
WASHINGTON DC
20005-2508
US

IV. Provider business mailing address

1743 RHODESIA AVE
FORT WASHINGTON MD
20744-3755
US

V. Phone/Fax

Practice location:
  • Phone: 202-545-6980
  • Fax: 877-839-6747
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN1035199
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: