Provider Demographics
NPI:1659144848
Name:OKOYE, PRINCESS ADAEZE
Entity Type:Individual
Prefix:
First Name:PRINCESS
Middle Name:ADAEZE
Last Name:OKOYE
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 1:1309 NORTHERN LIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-6056
Mailing Address - Country:US
Mailing Address - Phone:240-486-8735
Mailing Address - Fax:
Practice Address - Street 1:1309 NORTHERN LIGHTS DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-6056
Practice Address - Country:US
Practice Address - Phone:240-486-8735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC376K00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide