Healthcare Provider Details

I. General information

NPI: 1740066166
Provider Name (Legal Business Name): OJIUGO ASHLEY OKAFOR APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2023
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HORIZON CENTER BLVD
HAMILTON NJ
08691-1910
US

IV. Provider business mailing address

48 FOXCHASE DR
BURLINGTON NJ
08016-3046
US

V. Phone/Fax

Practice location:
  • Phone: 484-542-2985
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ01472000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: