Provider Demographics
NPI:1992372163
Name:OKAFOR, JENNIFER CHIKA
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CHIKA
Last Name:OKAFOR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 HILLSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-7446
Mailing Address - Country:US
Mailing Address - Phone:972-623-8639
Mailing Address - Fax:
Practice Address - Street 1:4630 LONG PRAIRIE RD STE 210
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1964
Practice Address - Country:US
Practice Address - Phone:469-495-9112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1012027207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine