MEDICARE: FAITH ITOHAN OMOREGIE RN

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	163W00000X	Registered Nurse	13-135288-051	KS

General Provider Information

NPI Number	:	1801383344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAITH ITOHAN OMOREGIE RN

Provider Business Mailing Address
First Line	:	3590 CONCHITA DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-1102
Country	:	US
Telephone Number	:	443-878-6245
Fax Number	:

Provider Business Practice Location Address
First Line	:	3590 CONCHITA DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-1102
Country	:	US
Telephone Number	:	443-878-6245
Fax Number	:

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

Provider Enumeration Date	:	04/19/2018
Last Update Date	:	04/08/2026

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