Provider Demographics
NPI:1154931376
Name:OKOLI, CHINELO (NP)
Entity type:Individual
Prefix:
First Name:CHINELO
Middle Name:
Last Name:OKOLI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13601 PINNACLE CIR W APT 2202
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-7666
Mailing Address - Country:US
Mailing Address - Phone:512-363-8885
Mailing Address - Fax:
Practice Address - Street 1:600 N CENTRAL EXPY STE 601
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6771
Practice Address - Country:US
Practice Address - Phone:972-424-6311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143521363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health