Provider Demographics
NPI:1528533965
Name:ONYIRIOHA, REBECCA BRIANNE (RN,MSN,IBCLC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:BRIANNE
Last Name:ONYIRIOHA
Suffix:
Gender:F
Credentials:RN,MSN,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S BLISS AVE
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-2512
Mailing Address - Country:US
Mailing Address - Phone:918-458-3638
Mailing Address - Fax:918-458-3610
Practice Address - Street 1:100 S BLISS AVE
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-2512
Practice Address - Country:US
Practice Address - Phone:918-458-3638
Practice Address - Fax:918-458-3610
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK141705163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant