Provider Demographics
NPI:1114648151
Name:EJIOFOR-OKOLI, JOAN UKAMAKA (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:UKAMAKA
Last Name:EJIOFOR-OKOLI
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 WASHINGTON RD STE 110A
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5779
Mailing Address - Country:US
Mailing Address - Phone:410-751-7480
Mailing Address - Fax:
Practice Address - Street 1:826 WASHINGTON RD STE 110A
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5779
Practice Address - Country:US
Practice Address - Phone:410-751-7480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR191164363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily