Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LG0600X | Nurse Practitioner - Gerontology | R174691 | MD |
Y | 363LG0600X | Nurse Practitioner - Gerontology | RN1012764 | DC |
NPI | 1073860466 |
---|---|
Provider Name | Josephine Nwoko |
First Address | Millersville, MD 21108-1547 |
Second Address | Millersville, MD 21108-1547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2012 |
Last Update Date | 01/02/2016 |