Provider Demographics
NPI:1043794043
Name:OKORAFOR, ADAOBI
Entity Type:Individual
Prefix:
First Name:ADAOBI
Middle Name:
Last Name:OKORAFOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 KENILWORTH AVE APT 410E
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-2132
Mailing Address - Country:US
Mailing Address - Phone:202-840-3595
Mailing Address - Fax:
Practice Address - Street 1:3801 KENILWORTH AVE APT 410E
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-2132
Practice Address - Country:US
Practice Address - Phone:202-840-3595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13977374U00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide