Healthcare Provider Details

I. General information

NPI: 1265049969
Provider Name (Legal Business Name): CHRISTABEL OBUMNEKE OKOYE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2020
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 WINDSOR ST SW STE 309
ATLANTA GA
30312-2530
US

IV. Provider business mailing address

6207 NELLIE CT SE
MABLETON GA
30126-4452
US

V. Phone/Fax

Practice location:
  • Phone: 404-688-9202
  • Fax:
Mailing address:
  • Phone: 404-425-8011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number163130
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN163130
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: