Provider Demographics
NPI:1043891377
Name:OKAFOR, NWA PRINCESS
Entity Type:Individual
Prefix:
First Name:NWA
Middle Name:PRINCESS
Last Name:OKAFOR
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 1:18 MULBERRY LN APT 18
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-5547
Mailing Address - Country:US
Mailing Address - Phone:609-375-5961
Mailing Address - Fax:
Practice Address - Street 1:18 MULBERRY LN APT 18
Practice Address - Street 2:
Practice Address - City:BELLE MEAD
Practice Address - State:NJ
Practice Address - Zip Code:08502-5547
Practice Address - Country:US
Practice Address - Phone:609-375-5961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY341033164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse