Healthcare Provider Details

I. General information

NPI: 1447509757
Provider Name (Legal Business Name): CONSTANCE UKAMAKA OKAFOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CONSTANCE UKAMAKA EZEZUDU

II. Dates (important events)

Enumeration Date: 08/31/2012
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7506 GEORGIA AVE NW
WASHINGTON DC
20012-1608
US

IV. Provider business mailing address

7506 GEORGIA AVE NW
WASHINGTON DC
20012-1608
US

V. Phone/Fax

Practice location:
  • Phone: 202-291-6973
  • Fax: 202-291-7018
Mailing address:
  • Phone: 202-291-6973
  • Fax: 202-291-7018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA10073
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: