Provider Demographics
NPI:1508514282
Name:OKEEFE, CHRISTOPHER THOMAS (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:THOMAS
Last Name:OKEEFE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1189 W 23RD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-4313
Mailing Address - Country:US
Mailing Address - Phone:925-334-8310
Mailing Address - Fax:
Practice Address - Street 1:1189 W 23RD ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-4313
Practice Address - Country:US
Practice Address - Phone:925-334-8310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-12
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
232992374T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing PersonnelGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA232992OtherHMO PPO EPO ETC