Provider Demographics
NPI:1215170238
Name:OKOKO, CHRISTIAN OFU (RN)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:OFU
Last Name:OKOKO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16000 TERRACE RD APT 202
Mailing Address - Street 2:
Mailing Address - City:EAST CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-2067
Mailing Address - Country:US
Mailing Address - Phone:216-761-6363
Mailing Address - Fax:
Practice Address - Street 1:16000 TERRACE RD APT 202
Practice Address - Street 2:
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-2067
Practice Address - Country:US
Practice Address - Phone:216-761-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 344992372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion