Healthcare Provider Details

I. General information

NPI: 1538723143
Provider Name (Legal Business Name): FLORENCE OKOJIE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2019
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 C ST STE G
LAUREL MD
20707
US

IV. Provider business mailing address

13 C ST STE G
LAUREL MD
20707-4152
US

V. Phone/Fax

Practice location:
  • Phone: 240-281-3272
  • Fax:
Mailing address:
  • Phone: 240-281-3272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR195404
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: