Provider Demographics
NPI:1134531809
Name:OKEKE, CHIKE OLISAELOKA (CNA)
Entity type:Individual
Prefix:
First Name:CHIKE
Middle Name:OLISAELOKA
Last Name:OKEKE
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4952 NAFF RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-3680
Mailing Address - Country:US
Mailing Address - Phone:702-589-0054
Mailing Address - Fax:
Practice Address - Street 1:4952 NAFF RIDGE DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-3680
Practice Address - Country:US
Practice Address - Phone:702-589-0054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCNA028806376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV$$$$$$$$$Medicare PIN