Healthcare Provider Details

I. General information

NPI: 1366335952
Provider Name (Legal Business Name): EMERENCIA OKIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 CARA DR
SPRINGDALE MD
20774-5438
US

IV. Provider business mailing address

3605 CARA DR
SPRINGDALE MD
20774-5438
US

V. Phone/Fax

Practice location:
  • Phone: 240-932-8274
  • Fax:
Mailing address:
  • Phone: 240-932-8274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200004742
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: