Provider Demographics
NPI:1417579665
Name:OFFIAH, ANTHONIA CHINYERE
Entity Type:Individual
Prefix:
First Name:ANTHONIA
Middle Name:CHINYERE
Last Name:OFFIAH
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 1:9211 STUART LN
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2712
Mailing Address - Country:US
Mailing Address - Phone:240-938-8532
Mailing Address - Fax:
Practice Address - Street 1:11005 ATWELL AVE
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3502
Practice Address - Country:US
Practice Address - Phone:240-938-8532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-11
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR226263163WG0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice