Healthcare Provider Details

I. General information

NPI: 1588938948
Provider Name (Legal Business Name): NNENNA A. OKORO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2012
Last Update Date: 03/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 SMITH ST
HOUSTON TX
77002-7327
US

IV. Provider business mailing address

9359 SHADY LANE CIR
HOUSTON TX
77063-1306
US

V. Phone/Fax

Practice location:
  • Phone: 713-372-5921
  • Fax: 713-372-5941
Mailing address:
  • Phone: 713-372-5921
  • Fax: 713-372-5941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number458643
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: