MEDICARE: BERNARDINE N OKPALA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1104415793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERNARDINE N OKPALA

Provider Business Mailing Address
First Line	:	5412 RICHARDSONS ENDEAVOR DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-3395
Country	:	US
Telephone Number	:	240-583-7493
Fax Number	:

Provider Business Practice Location Address
First Line	:	9420 ANNAPOLIS RD STE 306
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-3021
Country	:	US
Telephone Number	:	240-583-7493
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BERNARDINE N OKPALA
Credential	:
Telephone Number	:	202-299-5100

Provider Enumeration Date	:	01/18/2021
Last Update Date	:	04/13/2026

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Directions to “BERNARDINE N OKPALA ” Practice Location

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