Provider Demographics
NPI:1578933230
Name:OKEH, JENNIFER IJEOMA (FNP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:IJEOMA
Last Name:OKEH
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 1:1550 TERRELL MILL RD SE APT 17T
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-6073
Mailing Address - Country:US
Mailing Address - Phone:678-849-5774
Mailing Address - Fax:
Practice Address - Street 1:1550 TERRELL MILL RD SE APT 17T
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-6073
Practice Address - Country:US
Practice Address - Phone:678-849-5774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN213830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily