Provider Demographics
NPI:1568899193
Name:OFILI, MIRIAM NGOZI (FNP)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:NGOZI
Last Name:OFILI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:NGOZI
Other - Last Name:OFILI-OKAFOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1844 E DIMONDALE DR
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-2919
Mailing Address - Country:US
Mailing Address - Phone:310-531-4081
Mailing Address - Fax:
Practice Address - Street 1:1844 E DIMONDALE DR
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-2919
Practice Address - Country:US
Practice Address - Phone:310-531-4081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23620363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily