Provider Demographics
NPI:1225571474
Name:NWOKORIE, ELEVATE
Entity Type:Individual
Prefix:
First Name:ELEVATE
Middle Name:
Last Name:NWOKORIE
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 1:4309 ROCKPORT LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3409
Mailing Address - Country:US
Mailing Address - Phone:202-378-3100
Mailing Address - Fax:
Practice Address - Street 1:4309 ROCKPORT LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3409
Practice Address - Country:US
Practice Address - Phone:202-378-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12532374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide