Provider Demographics
NPI:1033492954
Name:ULOKO, EMMANUEL OLUSHOLA SR (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:OLUSHOLA
Last Name:ULOKO
Suffix:SR
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-277-1800
Mailing Address - Fax:336-277-9538
Practice Address - Street 1:3333 SILAS CREEK PARKWAY
Practice Address - Street 2:FORSYTH MEDICAL CENTER
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103
Practice Address - Country:US
Practice Address - Phone:336-718-5000
Practice Address - Fax:336-718-9847
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005303363L00000X, 364SP0809X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult