Provider Demographics
NPI:1154028611
Name:OKOLI, CHEKWUBE MARTHA (APRN)
Entity type:Individual
Prefix:
First Name:CHEKWUBE
Middle Name:MARTHA
Last Name:OKOLI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 CASSINIA PKWY
Mailing Address - Street 2:
Mailing Address - City:HEARTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75126-0788
Mailing Address - Country:US
Mailing Address - Phone:214-623-7837
Mailing Address - Fax:
Practice Address - Street 1:3023 CASSINIA PKWY
Practice Address - Street 2:
Practice Address - City:HEARTLAND
Practice Address - State:TX
Practice Address - Zip Code:75126-0788
Practice Address - Country:US
Practice Address - Phone:214-623-7837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1109879363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily