Provider Demographics
NPI:1194345611
Name:OKECHUKWU, PERPETUA ADANNA (MD)
Entity type:Individual
Prefix:
First Name:PERPETUA
Middle Name:ADANNA
Last Name:OKECHUKWU
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:PERPETUA
Other - Middle Name:ADANNA
Other - Last Name:OKOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2810 NICOLLET AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-4708
Mailing Address - Country:US
Mailing Address - Phone:612-873-8088
Mailing Address - Fax:
Practice Address - Street 1:2810 NICOLLET AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-4708
Practice Address - Country:US
Practice Address - Phone:612-873-8088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-24
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN74161207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine