Healthcare Provider Details

I. General information

NPI: 1093399081
Provider Name (Legal Business Name): OLUWABUKUNOLA OLANREWAJU OKAFOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5715 6TH ST NW
WASHINGTON DC
20011-2001
US

IV. Provider business mailing address

5715 6TH ST NW
WASHINGTON DC
20011-2001
US

V. Phone/Fax

Practice location:
  • Phone: 202-878-5282
  • Fax:
Mailing address:
  • Phone: 202-878-5282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA00191438
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200002855
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: