Healthcare Provider Details

I. General information

NPI: 1093176729
Provider Name (Legal Business Name): CHINELO OKOYE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

346 MILL ST
HAGERSTOWN MD
21740-6138
US

IV. Provider business mailing address

346 MILL ST
HAGERSTOWN MD
21740-6138
US

V. Phone/Fax

Practice location:
  • Phone: 301-791-6680
  • Fax: 301-714-1506
Mailing address:
  • Phone: 301-791-6680
  • Fax: 301-714-1506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR269783
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number20099
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number26NJ00610800
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number20099
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: