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General NPI Number Information
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NPI Number | 1083457774
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Entity Type | Individual
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Provider Name | DORIS OFODILE PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/18/2024
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 1647 BENNING RD NE STE 300A
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City | WASHINGTON
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State | DC
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Zip | 20002-4572
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Country | US
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Telephone | 240-707-1120
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Fax |
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Provider Business Mailing Address
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Address Line | 1647 BENNING RD NE STE 300A
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City | WASHINGTON
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State | DC
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Zip | 20002-4572
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | R243706
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | R243706
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | R243706
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R243706
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP1059356
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License Number State | DC
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