Healthcare Provider Details

I. General information

NPI: 1023745320
Provider Name (Legal Business Name): VENELINE OLORIFE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 S CHAPEL ST STE 102
NEWARK DE
19713-3468
US

IV. Provider business mailing address

133 ROLLINS AVE STE 3
ROCKVILLE MD
20852-4040
US

V. Phone/Fax

Practice location:
  • Phone: 302-224-1400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0010343
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: