Provider Demographics
NPI:1922676253
Name:OJINNAKA, PRINCESS THERESA
Entity Type:Individual
Prefix:
First Name:PRINCESS
Middle Name:THERESA
Last Name:OJINNAKA
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 1:9804 LAKE POINTE CT APT 758
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4716
Mailing Address - Country:US
Mailing Address - Phone:301-675-9211
Mailing Address - Fax:
Practice Address - Street 1:9804 LAKE POINTE CT APT 758
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-4716
Practice Address - Country:US
Practice Address - Phone:301-675-9211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA15301374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide