Healthcare Provider Details

I. General information

NPI: 1609793413
Provider Name (Legal Business Name): DKG HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9854 LIBERTY RD STE D
RANDALLSTOWN MD
21133-2058
US

IV. Provider business mailing address

9854 LIBERTY RD STE D
RANDALLSTOWN MD
21133-2058
US

V. Phone/Fax

Practice location:
  • Phone: 443-985-6175
  • Fax: 443-592-0220
Mailing address:
  • Phone: 443-985-6175
  • Fax: 443-592-0220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CYNTHIA OKONKWO
Title or Position: FAMILY NURSE PRACTITIONER
Credential: CRNP
Phone: 443-589-6355