Provider Demographics
NPI:1194204180
Name:NWOKOLO, NGOZI CAROLINE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:NGOZI
Middle Name:CAROLINE
Last Name:NWOKOLO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N CLASSEN BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-6611
Mailing Address - Country:US
Mailing Address - Phone:405-232-1090
Mailing Address - Fax:405-235-2832
Practice Address - Street 1:1515 N CLASSEN BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6611
Practice Address - Country:US
Practice Address - Phone:405-232-1090
Practice Address - Fax:405-235-2832
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKF05180200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine