Healthcare Provider Details

I. General information

NPI: 1093540064
Provider Name (Legal Business Name): NKECHI OKORO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2024
Last Update Date: 09/07/2024
Certification Date: 09/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1738 PLEASANTVILLE RD
FOREST HILL MD
21050-2308
US

IV. Provider business mailing address

1738 PLEASANTVILLE RD
FOREST HILL MD
21050-2308
US

V. Phone/Fax

Practice location:
  • Phone: 443-326-3862
  • Fax:
Mailing address:
  • Phone: 443-326-3862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR153973
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR153973
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: