Provider Demographics
NPI:1578763447
Name:OKOLOCHA, EUNICE (FNP)
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:
Last Name:OKOLOCHA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 FITZGERALD DR
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-4204
Mailing Address - Country:US
Mailing Address - Phone:219-924-1249
Mailing Address - Fax:
Practice Address - Street 1:2054 GRANT ST
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46404-3060
Practice Address - Country:US
Practice Address - Phone:219-949-7540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28126804A163W00000X
IL041-307615163W00000X
IN71003782363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse