Provider Demographics
NPI:1740410539
Name:NWOKE, PAULINE N (LPN, RN, FNP, GNP,)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:N
Last Name:NWOKE
Suffix:
Gender:F
Credentials:LPN, RN, FNP, GNP,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14401 256TH ST
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-2542
Mailing Address - Country:US
Mailing Address - Phone:718-949-1819
Mailing Address - Fax:
Practice Address - Street 1:754 E 151ST ST # 10455
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-3267
Practice Address - Country:US
Practice Address - Phone:718-993-3006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2222071164W00000X
NYF332244-1363LF0000X
NY4479701163W00000X
NYF3403281363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology