Healthcare Provider Details

I. General information

NPI: 1023751732
Provider Name (Legal Business Name): PATIENCE CHINENYE OKOLO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 7TH ST
ROBINS AFB GA
31098-2227
US

IV. Provider business mailing address

655 7TH ST
ROBINS AFB GA
31098-2227
US

V. Phone/Fax

Practice location:
  • Phone: 478-327-7850
  • Fax:
Mailing address:
  • Phone: 478-327-7850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP234573
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: