Provider Demographics
NPI:1578035226
Name:OKIOMA, DOROTHY NYAKERARIO
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:NYAKERARIO
Last Name:OKIOMA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DOROTHY
Other - Middle Name:NYAKERARIO
Other - Last Name:OKIOMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE
Mailing Address - Street 1:811 INTERSTATE 45 S APT 234
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-4212
Mailing Address - Country:US
Mailing Address - Phone:862-899-4727
Mailing Address - Fax:
Practice Address - Street 1:602 W SEMANDS ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1867
Practice Address - Country:US
Practice Address - Phone:935-756-5598
Practice Address - Fax:936-249-2244
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX952146163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse