Provider Demographics
NPI:1134374374
Name:EKOKO, VICTORINE TENGU (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:VICTORINE
Middle Name:TENGU
Last Name:EKOKO
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:VICTORINE
Other - Middle Name:TENGU
Other - Last Name:FOMBO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8308 LONESOME SPUR TRL
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2608
Mailing Address - Country:US
Mailing Address - Phone:513-807-1101
Mailing Address - Fax:
Practice Address - Street 1:4124 ALSACE LN
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-7324
Practice Address - Country:US
Practice Address - Phone:513-807-1101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX920605163W00000X
TXAP135210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse