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General NPI Number Information
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NPI Number | 1164621165
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Entity Type | Individual
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Provider Name | EKEI EKPO-ITA MBUKPA OTR
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Gender | Female
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 2212 SCHICKASAW TRAL #1167
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City | ORLANDO
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State | FL
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Zip | 32825-2730
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Country | US
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Telephone | 832-820-7229
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Fax |
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Provider Business Mailing Address
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Address Line | 461 KIRK RD APT 1A
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-2931
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Country | US
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Telephone | 832-820-7229
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 029649
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 006520-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 018744
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 56490
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License Number State | WY
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