Healthcare Provider Details

I. General information

NPI: 1396059671
Provider Name (Legal Business Name): JOY OYINADE OKORUWA APRN-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 06/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

988102 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8102
US

IV. Provider business mailing address

987442 NEBRASKA MEDICAL CENTER
OMAHA NE
68198-7442
US

V. Phone/Fax

Practice location:
  • Phone: 402-595-2280
  • Fax: 402-595-2283
Mailing address:
  • Phone: 402-559-4000
  • Fax: 402-595-2283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number111046
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number111046
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: