Provider Demographics
NPI:1659018919
Name:OKADE, ANTHONY ONYEISI (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:ONYEISI
Last Name:OKADE
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 WESTER RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-4804
Mailing Address - Country:US
Mailing Address - Phone:919-412-3586
Mailing Address - Fax:
Practice Address - Street 1:3916 WESTER RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-4804
Practice Address - Country:US
Practice Address - Phone:919-412-3586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF07220851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily