Provider Demographics
NPI:1972092740
Name:OBIKE, YVONNE NONYELUM (CRNP)
Entity type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:NONYELUM
Last Name:OBIKE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1300 MERCANTILE LN STE 200
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5340
Mailing Address - Country:US
Mailing Address - Phone:301-357-9751
Mailing Address - Fax:
Practice Address - Street 1:5457 TWIN KNOLLS RD STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3263
Practice Address - Country:US
Practice Address - Phone:410-689-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR208795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily