Provider Demographics
NPI:1326346495
Name:OKENE, TAWANA NICOLE (REGISTERED NURSE(RN))
Entity Type:Individual
Prefix:
First Name:TAWANA
Middle Name:NICOLE
Last Name:OKENE
Suffix:
Gender:F
Credentials:REGISTERED NURSE(RN)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219-43 PECK AVE.
Mailing Address - Street 2:
Mailing Address - City:HOLLIS-HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11427
Mailing Address - Country:US
Mailing Address - Phone:718-776-6966
Mailing Address - Fax:
Practice Address - Street 1:21943 PECK AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-1121
Practice Address - Country:US
Practice Address - Phone:718-776-6966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY615431-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse