Healthcare Provider Details

I. General information

NPI: 1962055723
Provider Name (Legal Business Name): FRANCISCA NKEM OKWUKOGU RN, BSN, MSN, PMHNP-
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16701 MELFORD BLVD STE 400
BOWIE MD
20715-4411
US

IV. Provider business mailing address

16701 MELFORD BLVD STE 400
BOWIE MD
20715-4411
US

V. Phone/Fax

Practice location:
  • Phone: 240-510-3281
  • Fax:
Mailing address:
  • Phone: 240-510-3281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR210229
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: