Provider Demographics
NPI:1447551072
Name:OKONJO, ERONMWON YVONNE (CRNP)
Entity type:Individual
Prefix:MS
First Name:ERONMWON
Middle Name:YVONNE
Last Name:OKONJO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 WASHINGTON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ARBUTUS
Mailing Address - State:MD
Mailing Address - Zip Code:21227-1660
Mailing Address - Country:US
Mailing Address - Phone:410-646-0001
Mailing Address - Fax:410-646-1600
Practice Address - Street 1:3720 WASHINGTON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ARBUTUS
Practice Address - State:MD
Practice Address - Zip Code:21227-1660
Practice Address - Country:US
Practice Address - Phone:410-646-0001
Practice Address - Fax:410-646-1600
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN161926163W00000X, 163WC1500X, 171M00000X
MDR161926363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator