Provider Demographics
NPI:1598027955
Name:OKYERE, HENRIETTA SERWAH
Entity Type:Individual
Prefix:
First Name:HENRIETTA
Middle Name:SERWAH
Last Name:OKYERE
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 1:3401 TOLEDO TER
Mailing Address - Street 2:APT L4
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-1939
Mailing Address - Country:US
Mailing Address - Phone:240-476-7976
Mailing Address - Fax:
Practice Address - Street 1:3401 TOLEDO TER
Practice Address - Street 2:APT L4
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-1939
Practice Address - Country:US
Practice Address - Phone:240-476-7976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDO-260-302-762-635374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide