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General NPI Number Information
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NPI Number | 1407656549
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Entity Type | Individual
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Provider Name | EDWARD MADUABUCHI OKEKE MSN, APRN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 2467 OLD CORNELIA HWY
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City | GAINESVILLE
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State | GA
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Zip | 30507-7853
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Country | US
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Telephone | 678-960-2700
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Fax | 678-513-5833
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Provider Business Mailing Address
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Address Line | 3009 SHIRECREST LN
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City | DACULA
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State | GA
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Zip | 30019-1689
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN-NP334320
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License Number State | GA
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