Provider Demographics
NPI:1275008393
Name:IDAKWOJI, FAITH (CRNP)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:IDAKWOJI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7527 STONES THROW CT
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-1232
Mailing Address - Country:US
Mailing Address - Phone:443-488-2326
Mailing Address - Fax:
Practice Address - Street 1:7527 STONES THROW CT
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-1232
Practice Address - Country:US
Practice Address - Phone:443-488-2326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR217850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F08181151OtherAMERICAN ACADEMY OF NURSE PRACTITIONER CERTIFICATION NUMBER