Provider Demographics
NPI:1124382767
Name:OKORIE, PEACE NKEIRUKA (NP)
Entity Type:Individual
Prefix:
First Name:PEACE
Middle Name:NKEIRUKA
Last Name:OKORIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 HANOVER DR
Mailing Address - Street 2:STE 301
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2249
Mailing Address - Country:US
Mailing Address - Phone:301-345-1800
Mailing Address - Fax:301-345-3854
Practice Address - Street 1:7300 HANOVER DR
Practice Address - Street 2:STE 301
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2249
Practice Address - Country:US
Practice Address - Phone:301-345-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR149680363L00000X
DCRN966872363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner