Healthcare Provider Details

I. General information

NPI: 1669656773
Provider Name (Legal Business Name): JOAN OBOITE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOAN CHINYERE UKEOMAH

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 GREENWAY CENTER DR STE 204
GREENBELT MD
20770-3525
US

IV. Provider business mailing address

14510 DEW DR
BOWIE MD
20721-3093
US

V. Phone/Fax

Practice location:
  • Phone: 240-542-4810
  • Fax: 240-254-3558
Mailing address:
  • Phone: 301-249-0848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR115822
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN52599
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: