Provider Demographics
NPI:1023345873
Name:OKONOFUA, DEBORAH EKIGHALO (FNP, DNP)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:EKIGHALO
Last Name:OKONOFUA
Suffix:
Gender:F
Credentials:FNP, DNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:EKIGHALO
Other - Last Name:OKONOFUA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:7100 BALTIMORE AVE STE 510
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-3641
Mailing Address - Country:US
Mailing Address - Phone:240-467-5739
Mailing Address - Fax:240-467-5795
Practice Address - Street 1:7100 BALTIMORE AVE STE 510
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-3641
Practice Address - Country:US
Practice Address - Phone:240-467-5739
Practice Address - Fax:240-467-5795
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-13
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1003033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC050790500Medicaid
MD0344478Medicaid