Provider Demographics
NPI:1104712421
Name:OKPALA, CHRISTIANA NONYELUM (NP)
Entity type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:NONYELUM
Last Name:OKPALA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHRISTIANA
Other - Middle Name:NONYELUM
Other - Last Name:OKPALA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:2384 MANAL WAY
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-8170
Mailing Address - Country:US
Mailing Address - Phone:404-791-2032
Mailing Address - Fax:404-592-9639
Practice Address - Street 1:2384 MANAL WAY
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-8170
Practice Address - Country:US
Practice Address - Phone:404-791-2032
Practice Address - Fax:404-592-9639
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN188580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily