Provider Demographics
NPI:1194366088
Name:LOKENI, MATALENA SUITUPE
Entity Type:Individual
Prefix:
First Name:MATALENA
Middle Name:SUITUPE
Last Name:LOKENI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7650 MAYFAIR DR APT C
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-7212
Mailing Address - Country:US
Mailing Address - Phone:907-903-5847
Mailing Address - Fax:
Practice Address - Street 1:7650 MAYFAIR DR APT C
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-7212
Practice Address - Country:US
Practice Address - Phone:907-903-5847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist