Healthcare Provider Details

I. General information

NPI: 1972475085
Provider Name (Legal Business Name): NATASHA OKONKWO DNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 BEVERLY GLEN BLVD APT 312
SHERMAN OAKS CA
91423
US

IV. Provider business mailing address

4300 BEVERLY GLEN BLVD APT 312
SHERMAN OAKS CA
91423
US

V. Phone/Fax

Practice location:
  • Phone: 720-496-8378
  • Fax:
Mailing address:
  • Phone: 720-496-8378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95129212
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: