Provider Demographics
NPI:1215522776
Name:OKUWA, TOLULOPE OLUYEMISI
Entity type:Individual
Prefix:MS
First Name:TOLULOPE
Middle Name:OLUYEMISI
Last Name:OKUWA
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 1:9921 GREENBELT RD APT 103
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2248
Mailing Address - Country:US
Mailing Address - Phone:631-464-2262
Mailing Address - Fax:
Practice Address - Street 1:9921 GREENBELT RD APT 103
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2248
Practice Address - Country:US
Practice Address - Phone:631-464-2262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-06
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide