Provider Demographics
NPI:1730679812
Name:OFILI, IMELDA (NP)
Entity Type:Individual
Prefix:
First Name:IMELDA
Middle Name:
Last Name:OFILI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:IMELDA
Other - Middle Name:
Other - Last Name:ONYEJE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10606 FITZGIBBON CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1849
Mailing Address - Country:US
Mailing Address - Phone:202-487-1527
Mailing Address - Fax:
Practice Address - Street 1:10606 FITZGIBBON CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1849
Practice Address - Country:US
Practice Address - Phone:202-487-1527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR178473363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily