Provider Demographics
NPI:1578867966
Name:OKWUOSAH, CORDELIA C (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CORDELIA
Middle Name:C
Last Name:OKWUOSAH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CORDELIA
Other - Middle Name:C
Other - Last Name:DOWDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:23491 VIA ALONDRA
Mailing Address - Street 2:
Mailing Address - City:TRABUCO CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:92679-3907
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23491 VIA ALONDRA
Practice Address - Street 2:
Practice Address - City:TRABUCO CANYON
Practice Address - State:CA
Practice Address - Zip Code:92679-3907
Practice Address - Country:US
Practice Address - Phone:619-567-9803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-29
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19862363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1578867966OtherNPI