Healthcare Provider Details

I. General information

NPI: 1932930765
Provider Name (Legal Business Name): ESTHER OKOROKWO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6808 MIDDLEFIELD RD
FORT WASHINGTON MD
20744-1044
US

IV. Provider business mailing address

6808 MIDDLEFIELD RD
FORT WASHINGTON MD
20744-1044
US

V. Phone/Fax

Practice location:
  • Phone: 240-443-0967
  • Fax:
Mailing address:
  • Phone: 240-443-0967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200003980
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: