Healthcare Provider Details

I. General information

NPI: 1114400066
Provider Name (Legal Business Name): OSEREMEN LAURETTA OKOJIE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 W ROLLING XRDS STE 111
CATONSVILLE MD
21228-6211
US

IV. Provider business mailing address

4 CYPRESS GROVE CT
OWINGS MILLS MD
21117-6703
US

V. Phone/Fax

Practice location:
  • Phone: 443-768-7995
  • Fax: 443-524-7811
Mailing address:
  • Phone: 443-768-7995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR172420
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR172420
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: