Healthcare Provider Details

I. General information

NPI: 1649529934
Provider Name (Legal Business Name): NNEKA OKOYE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2012
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 23RD ST NW ROOM G-1092
WASHINGTON DC
20037-2342
US

IV. Provider business mailing address

201 T ST NW UNIT B
WASHINGTON DC
20001-1835
US

V. Phone/Fax

Practice location:
  • Phone: 202-715-4569
  • Fax: 202-715-4587
Mailing address:
  • Phone: 540-998-1907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024170288
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: