Provider Demographics
NPI:1558064659
Name:OKEKE, OBIOMA LINDA
Entity Type:Individual
Prefix:MRS
First Name:OBIOMA
Middle Name:LINDA
Last Name:OKEKE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:OBIOMA
Other - Middle Name:LINDA
Other - Last Name:EKEKEZIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:53 NORWICH RD
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-2138
Mailing Address - Country:US
Mailing Address - Phone:617-543-5448
Mailing Address - Fax:
Practice Address - Street 1:53 NORWICH RD
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2138
Practice Address - Country:US
Practice Address - Phone:617-543-5448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2330220163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health