Provider Demographics
NPI:1306216080
Name:CHUKWUNYERE, OKAFOR
Entity Type:Individual
Prefix:
First Name:OKAFOR
Middle Name:
Last Name:CHUKWUNYERE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3679 CHILDRESS TER
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-2040
Mailing Address - Country:US
Mailing Address - Phone:240-603-8101
Mailing Address - Fax:
Practice Address - Street 1:3679 CHILDRESS TER
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-2040
Practice Address - Country:US
Practice Address - Phone:240-603-8101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11589374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide