Provider Demographics
NPI:1285119990
Name:OKORIE, PEACE IFEOMA
Entity type:Individual
Prefix:
First Name:PEACE
Middle Name:IFEOMA
Last Name:OKORIE
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 1:6208 BREEZEWOOD CT APT 203
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-4025
Mailing Address - Country:US
Mailing Address - Phone:202-393-9031
Mailing Address - Fax:
Practice Address - Street 1:6208 BREEZEWOOD CT APT 203
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-4025
Practice Address - Country:US
Practice Address - Phone:202-393-9031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13825374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide