Provider Demographics
NPI:1649763053
Name:OKPULOR, ROSEMARY O (CRNP)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:O
Last Name:OKPULOR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8510 LASALLE RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286
Mailing Address - Country:US
Mailing Address - Phone:410-339-3850
Mailing Address - Fax:410-339-3852
Practice Address - Street 1:8510 LASALLE RD
Practice Address - Street 2:SUITE 310
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286
Practice Address - Country:US
Practice Address - Phone:410-339-3850
Practice Address - Fax:410-339-3852
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR119102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily