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General NPI Number Information
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NPI Number | 1386127942
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Entity Type | Individual
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Provider Name | JOAN IFE UDEJIOFOR FNP
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Gender | Female
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 2240 M ST NW
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City | WASHINGTON
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State | DC
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Zip | 20037-1415
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Country | US
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Telephone | 202-296-9877
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Fax |
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Provider Business Mailing Address
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Address Line | 13205 GLOBAL ST
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City | BOWIE
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State | MD
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Zip | 20720-3856
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Country | US
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Telephone | 443-545-9777
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F08180305
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License Number State | MD
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