Healthcare Provider Details

I. General information

NPI: 1831623578
Provider Name (Legal Business Name): MRS. CATHERINE NWOKEAFOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15601 HUMBERSIDE WAY
UPPER MARLBORO MD
20774-8050
US

IV. Provider business mailing address

15601 HUMBERSIDE WAY
UPPER MARLBORO MD
20774-8050
US

V. Phone/Fax

Practice location:
  • Phone: 240-604-7105
  • Fax:
Mailing address:
  • Phone: 240-604-7105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR118190
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: