Provider Demographics
NPI:1124304159
Name:OKEKE, IJEOMA ADAMMA (APN)
Entity type:Individual
Prefix:
First Name:IJEOMA
Middle Name:ADAMMA
Last Name:OKEKE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 PIONEER CT
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-3604
Mailing Address - Country:US
Mailing Address - Phone:732-514-2150
Mailing Address - Fax:
Practice Address - Street 1:28 PIONEER CT
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-3604
Practice Address - Country:US
Practice Address - Phone:732-514-2150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-21
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00341200363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health