Healthcare Provider Details

I. General information

NPI: 1942919667
Provider Name (Legal Business Name): PRISCA OKWARA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 TOWER RD
BRISTOL PA
19007-3116
US

IV. Provider business mailing address

162 RUGBY DR
LANGHORNE PA
19047-8501
US

V. Phone/Fax

Practice location:
  • Phone: 215-785-3201
  • Fax:
Mailing address:
  • Phone: 215-858-8073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP026483
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPPA057293
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: