MEDICARE: CHRISTIAN OFU OKOKO RN

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	372600000X	Adult Companion	RN 344992	OH

General Provider Information

NPI Number	:	1215170238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN OFU OKOKO RN

Provider Business Mailing Address
First Line	:	16000 TERRACE RD APT 202
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-2067
Country	:	US
Telephone Number	:	216-761-6363
Fax Number	:

Provider Business Practice Location Address
First Line	:	16000 TERRACE RD APT 202
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-2067
Country	:	US
Telephone Number	:	216-761-6363
Fax Number	:

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

Provider Enumeration Date	:	04/07/2009
Last Update Date	:	04/07/2009

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