MEDICARE: NICOLE C OKEKE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	APN 001146	NV
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN001146	NV

General Provider Information

NPI Number	:	1164752879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE C OKEKE NP

Provider Business Mailing Address
First Line	:	3085 E FLAMINGO RD STE A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4385
Country	:	US
Telephone Number	:	702-436-0835
Fax Number	:	702-435-6212

Provider Business Practice Location Address
First Line	:	4270 S DECATUR BLVD STE B6
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-6802
Country	:	US
Telephone Number	:	702-485-2100
Fax Number	:	702-825-0091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2009
Last Update Date	:	04/12/2021

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Directions to “ NICOLE C OKEKE NP” Practice Location

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