Provider Demographics
NPI:1497417844
Name:OCHAKO, MARTHA KERUBO (PMHNP)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:KERUBO
Last Name:OCHAKO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 CHAPANOKE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-3433
Mailing Address - Country:US
Mailing Address - Phone:919-703-2845
Mailing Address - Fax:
Practice Address - Street 1:319 CHAPANOKE RD STE 120
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-3433
Practice Address - Country:US
Practice Address - Phone:919-703-2845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC281419163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health