Provider Demographics
NPI:1043072200
Name:OCHULOR, GRACE UZOAMAKA
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:UZOAMAKA
Last Name:OCHULOR
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 1:2811 GREAT OAK DR
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2716
Mailing Address - Country:US
Mailing Address - Phone:240-584-7372
Mailing Address - Fax:
Practice Address - Street 1:1905 E ST SE # 14
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2593
Practice Address - Country:US
Practice Address - Phone:202-673-9024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN200001559163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse