Provider Demographics
NPI:1114120730
Name:OKOYE-ANDERSSON, MERCY E (MD)
Entity Type:Individual
Prefix:DR
First Name:MERCY
Middle Name:E
Last Name:OKOYE-ANDERSSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MERCY
Other - Middle Name:
Other - Last Name:OKOYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4101 WOOLWORTH AVE
Mailing Address - Street 2:NEBRASKA WESTERN IOWA HCS/OMAHA VA
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1850
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4101 WOOLWORTH AVE
Practice Address - Street 2:NEBRASKA WESTERN IOWA HCS/OMAHA VA
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1850
Practice Address - Country:US
Practice Address - Phone:402-995-3602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-10
Last Update Date:2017-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0070860207R00000X
NE28738207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine