Healthcare Provider Details

I. General information

NPI: 1609279009
Provider Name (Legal Business Name): NOAH OKAFOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NOAH OKAFOR CNA LL

II. Dates (important events)

Enumeration Date: 09/30/2014
Last Update Date: 09/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4804 SWANNS MILL DR
DURHAM NC
27704-1492
US

IV. Provider business mailing address

4804 SWANNS MILL DR
DURHAM NC
27704-1492
US

V. Phone/Fax

Practice location:
  • Phone: 919-294-4954
  • Fax:
Mailing address:
  • Phone: 919-294-4954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number75312
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: