MEDICARE: LILIAN OKAFOR NURSE PRACTITIONER

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	363LG0600X	Gerontology Nurse Practitioner	0024187347	VA

General Provider Information

NPI Number	:	1235816760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIAN OKAFOR NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	8805 FENWICK HILLS PKWY
Second Line	:
City	:	TOANO
State	:	VA
Zip	:	23168-9356
Country	:	US
Telephone Number	:	937-248-6860
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 COUSINS AVE
Second Line	:
City	:	HOPEWELL
State	:	VA
Zip	:	23860-6507
Country	:	US
Telephone Number	:	804-458-6325
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2023
Last Update Date	:	06/27/2023

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