Provider Demographics
NPI:1538676291
Name:ALKOKA, CONNIE MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:MARIE
Last Name:ALKOKA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 E STANFORD ST
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-4853
Mailing Address - Country:US
Mailing Address - Phone:615-400-1212
Mailing Address - Fax:
Practice Address - Street 1:620 E STANFORD ST
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-4853
Practice Address - Country:US
Practice Address - Phone:615-400-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9289676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily