Provider Demographics
NPI:1194044925
Name:OKORO, ROSELINE OLUCHI (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:ROSELINE
Middle Name:OLUCHI
Last Name:OKORO
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24603 LAKE PATH CIR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-2716
Mailing Address - Country:US
Mailing Address - Phone:281-608-1392
Mailing Address - Fax:
Practice Address - Street 1:963 S MASON RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-3873
Practice Address - Country:US
Practice Address - Phone:281-398-1445
Practice Address - Fax:281-398-1448
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2013-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX819060363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
299422YTSTOtherMEDICARE PTAN
299314OtherMEDICARE PTAN