Provider Demographics
NPI:1104702703
Name:OKAFOR, EMELINE SEWOYEBAA
Entity type:Individual
Prefix:
First Name:EMELINE
Middle Name:SEWOYEBAA
Last Name:OKAFOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12177 LAKE FERN DR E, JACKSONVILLE FLORIDA
Mailing Address - Street 2:
Mailing Address - City:NOT HISPANIC/LATINO/LATINA
Mailing Address - State:FL
Mailing Address - Zip Code:32258
Mailing Address - Country:US
Mailing Address - Phone:904-343-5987
Mailing Address - Fax:904-343-5987
Practice Address - Street 1:2732 TROLLIE LN
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-3833
Practice Address - Country:US
Practice Address - Phone:904-289-1254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11041532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily