Healthcare Provider Details

I. General information

NPI: 1508514282
Provider Name (Legal Business Name): CHRISTOPHER THOMAS OKEEFE NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2022
Last Update Date: 03/12/2022
Certification Date: 03/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1189 W 23RD ST
JACKSONVILLE FL
32209-4313
US

IV. Provider business mailing address

1189 W 23RD ST
JACKSONVILLE FL
32209-4313
US

V. Phone/Fax

Practice location:
  • Phone: 925-334-8310
  • Fax:
Mailing address:
  • Phone: 925-334-8310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374T00000X
TaxonomyReligious Nonmedical Nursing Personnel
License Number232992
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: