Provider Demographics
NPI:1437694205
Name:OKOYE, GLORIA EBERECHUKWU (FNP)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:EBERECHUKWU
Last Name:OKOYE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 ROCK HILL PKWY
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-3657
Mailing Address - Country:US
Mailing Address - Phone:310-384-3058
Mailing Address - Fax:
Practice Address - Street 1:632 ROCK HILL PKWY
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-3657
Practice Address - Country:US
Practice Address - Phone:310-384-3058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN189783163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse