Provider Demographics
NPI:1740847805
Name:OJIRINNAKA, CELESTINA
Entity type:Individual
Prefix:
First Name:CELESTINA
Middle Name:
Last Name:OJIRINNAKA
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 1:2714 LAKE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8854
Mailing Address - Country:US
Mailing Address - Phone:301-651-5326
Mailing Address - Fax:
Practice Address - Street 1:2714 LAKE FOREST DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-8854
Practice Address - Country:US
Practice Address - Phone:301-651-5326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR180997363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR180997OtherCRNP-FAMILY