Healthcare Provider Details

I. General information

NPI: 1194044925
Provider Name (Legal Business Name): ROSELINE OLUCHI OKORO DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2010
Last Update Date: 09/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

963 S MASON RD
KATY TX
77450-3873
US

IV. Provider business mailing address

24603 LAKE PATH CIR
KATY TX
77493-2716
US

V. Phone/Fax

Practice location:
  • Phone: 281-398-1445
  • Fax: 281-398-1448
Mailing address:
  • Phone: 281-608-1392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number819060
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: