Provider Demographics
NPI:1609187970
Name:OKUNOGHAE, EVELYN (APRN, FNP-BC, DNP)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:OKUNOGHAE
Suffix:
Gender:F
Credentials:APRN, FNP-BC, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9304 FOREST LN STE N177
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6238
Mailing Address - Country:US
Mailing Address - Phone:214-713-8228
Mailing Address - Fax:
Practice Address - Street 1:9304 FOREST LN STE N177
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6238
Practice Address - Country:US
Practice Address - Phone:214-713-8228
Practice Address - Fax:435-292-6684
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP117057363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily