Healthcare Provider Details

I. General information

NPI: 1558915173
Provider Name (Legal Business Name): NKECHI OKONTA DNP, NP-C, MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date: 07/18/2024
Reactivation Date: 08/08/2024

III. Provider practice location address

5764 PEACHTREE INDUSTRIAL BLVD
CHAMBLEE GA
30341-1908
US

IV. Provider business mailing address

5764 PEACHTREE INDUSTRIAL BLVD
CHAMBLEE GA
30341-1908
US

V. Phone/Fax

Practice location:
  • Phone: 770-457-4401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP199225
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: