Provider Demographics
NPI:1891219176
Name:OKORONO, AGNES (RN)
Entity Type:Individual
Prefix:MS
First Name:AGNES
Middle Name:
Last Name:OKORONO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7404 TOWN CENTER BLVD APT 703
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-6229
Mailing Address - Country:US
Mailing Address - Phone:832-818-4774
Mailing Address - Fax:
Practice Address - Street 1:7404 TOWN CENTER BLVD APT 703
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-6229
Practice Address - Country:US
Practice Address - Phone:832-818-4774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX914916163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse