Provider Demographics
NPI:1487293395
Name:OKPARA, QUEEN-KAREN
Entity type:Individual
Prefix:
First Name:QUEEN-KAREN
Middle Name:
Last Name:OKPARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 BUCKNELL TER
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-5530
Mailing Address - Country:US
Mailing Address - Phone:404-822-1524
Mailing Address - Fax:
Practice Address - Street 1:5760 W LITTLE YORK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-1112
Practice Address - Country:US
Practice Address - Phone:281-707-7359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1142623363LF0000X
GA251359363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily