Healthcare Provider Details

I. General information

NPI: 1164557435
Provider Name (Legal Business Name): MARYJOY OGOCHUKWU OKAFOR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 KADY LN
COLUMBUS OH
43232-7455
US

IV. Provider business mailing address

3301 KADY LN
COLUMBUS OH
43232-7455
US

V. Phone/Fax

Practice location:
  • Phone: 614-837-9168
  • Fax:
Mailing address:
  • Phone: 614-837-9168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.345768
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: