Provider Demographics
NPI:1386127942
Name:UDEJIOFOR, JOAN IFE (FNP)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:IFE
Last Name:UDEJIOFOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13205 GLOBAL ST
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3856
Mailing Address - Country:US
Mailing Address - Phone:443-545-9777
Mailing Address - Fax:
Practice Address - Street 1:2240 M ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1415
Practice Address - Country:US
Practice Address - Phone:202-296-9877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDF08180305363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily