Provider Demographics
NPI:1083149447
Name:OFOKANSI, IJEOMA (DNP, PMHNP, APRN)
Entity Type:Individual
Prefix:MRS
First Name:IJEOMA
Middle Name:
Last Name:OFOKANSI
Suffix:
Gender:F
Credentials:DNP, PMHNP, APRN
Other - Prefix:
Other - First Name:IJEOMA
Other - Middle Name:
Other - Last Name:OFOKANSI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP, PMHNP, APRN
Mailing Address - Street 1:13506 SUMMERPORT VILLAGE PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-7366
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7208 W SAND LAKE RD STE 305
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5279
Practice Address - Country:US
Practice Address - Phone:407-410-8621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9212488363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health