Provider Demographics
NPI:1669656773
Name:OBOITE, JOAN (APRN)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:OBOITE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:CHINYERE
Other - Last Name:UKEOMAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14510 DEW DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3093
Mailing Address - Country:US
Mailing Address - Phone:301-249-0848
Mailing Address - Fax:
Practice Address - Street 1:920 2ND AVE S
Practice Address - Street 2:SUITE 400
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-3318
Practice Address - Country:US
Practice Address - Phone:186-638-9272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN52599363LF0000X
MDR115822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily