MEDICARE: CHRISTIAN CHIDOZIE OKOLOEDO 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	004205	OH
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11029259	FL
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	4704448490	MI
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61568960	WA
5	363LP2300X	Primary Care Nurse Practitioner	848154	TX
6	363LA2200X	Adult Health Nurse Practitioner	311843	AZ
7	363LG0600X	Gerontology Nurse Practitioner	311843	AZ
8	363LG0600X	Gerontology Nurse Practitioner	848154	TX
9	363LA2200X	Adult Health Nurse Practitioner	848154	TX
10	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024197740	VA
11	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	311843	AZ

General Provider Information

NPI Number	:	1669953816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN CHIDOZIE OKOLOEDO NP

Provider Business Mailing Address
First Line	:	4419 HIDDEN OAKS WAY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-7397
Country	:	US
Telephone Number	:	832-343-5016
Fax Number	:

Provider Business Practice Location Address
First Line	:	824 N 99TH AVE STE 109
Second Line	:
City	:	AVONDALE
State	:	AZ
Zip	:	85323-5327
Country	:	US
Telephone Number	:	623-907-1457
Fax Number	:

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

Provider Enumeration Date	:	08/26/2018
Last Update Date	:	06/08/2026

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