Healthcare Provider Details

I. General information

NPI: 1164925715
Provider Name (Legal Business Name): SIMPLICIUS E OKORO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2018
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S PERIMETER PARK DR STE 100
NASHVILLE TN
37211-4128
US

IV. Provider business mailing address

301 S PERIMETER PARK DR STE 100
NASHVILLE TN
37211-4128
US

V. Phone/Fax

Practice location:
  • Phone: 615-930-9391
  • Fax:
Mailing address:
  • Phone: 615-930-9391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number220042
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number220042
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number220042
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: