Provider Demographics
NPI:1609279009
Name:OKAFOR, NOAH
Entity Type:Individual
Prefix:
First Name:NOAH
Middle Name:
Last Name:OKAFOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NOAH
Other - Middle Name:
Other - Last Name:OKAFOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNA LL
Mailing Address - Street 1:4804 SWANNS MILL DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-1492
Mailing Address - Country:US
Mailing Address - Phone:919-294-4954
Mailing Address - Fax:
Practice Address - Street 1:4804 SWANNS MILL DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-1492
Practice Address - Country:US
Practice Address - Phone:919-294-4954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC75312146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC75312OtherNORTH CAROLINA BOARD OF NURSING