Healthcare Provider Details

I. General information

NPI: 1932685047
Provider Name (Legal Business Name): MRS. ADAOMA NWAMAKA OKOYE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 07/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 BRIGHTSEAT RD APT 103
LANDOVER MD
20785-3750
US

IV. Provider business mailing address

1502 BRIGHTSEAT RD APT 103
LANDOVER MD
20785-3750
US

V. Phone/Fax

Practice location:
  • Phone: 240-470-2227
  • Fax:
Mailing address:
  • Phone: 240-470-2227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA13653
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: