Healthcare Provider Details

I. General information

NPI: 1174969448
Provider Name (Legal Business Name): CHIKA E OKAFOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2013
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SE 2ND ST STE 100
LEES SUMMIT MO
64063-2759
US

IV. Provider business mailing address

10942 W 74TH TER
SHAWNEE KS
66203-4420
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-6170
  • Fax:
Mailing address:
  • Phone: 913-601-0951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2010009931
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: