Provider Demographics
NPI:1548681893
Name:OFFOR, CAROLINE IHEKEREMMA (RN, BSN, VENT CN)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:IHEKEREMMA
Last Name:OFFOR
Suffix:
Gender:F
Credentials:RN, BSN, VENT CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 DEERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53716-1825
Mailing Address - Country:US
Mailing Address - Phone:608-234-8059
Mailing Address - Fax:
Practice Address - Street 1:1517 DEERWOOD DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53716-1825
Practice Address - Country:US
Practice Address - Phone:608-234-8059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI100354-030163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics