Provider Demographics
NPI:1316119118
Name:NWOKEJI, STELLA E (PHD, NP-BC)
Entity type:Individual
Prefix:DR
First Name:STELLA
Middle Name:E
Last Name:NWOKEJI
Suffix:
Gender:F
Credentials:PHD, NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1779 KIRBY PKWY # 1-72
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3666
Mailing Address - Country:US
Mailing Address - Phone:901-758-1675
Mailing Address - Fax:
Practice Address - Street 1:6575 QUAIL POINTE CIR S
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-1332
Practice Address - Country:US
Practice Address - Phone:901-758-1675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000012211363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341787Medicare PIN
TN103I500477Medicare PIN