Provider Demographics
NPI:1891315131
Name:OKPALA, NDIDIAMAKA (CNA)
Entity Type:Individual
Prefix:
First Name:NDIDIAMAKA
Middle Name:
Last Name:OKPALA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4209 OGLETHORPE ST APT 102
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-1537
Mailing Address - Country:US
Mailing Address - Phone:443-683-4372
Mailing Address - Fax:
Practice Address - Street 1:1508 E CAPITOL ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-1507
Practice Address - Country:US
Practice Address - Phone:202-371-9393
Practice Address - Fax:202-697-5069
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCA00173797103TH0100X
DCHHA15351374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service