Provider Demographics
NPI:1265809537
Name:OKPAREKE, NDIDIAMAKA (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:NDIDIAMAKA
Middle Name:
Last Name:OKPAREKE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 WELLSPRING AVE SE STE A
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-4957
Mailing Address - Country:US
Mailing Address - Phone:505-738-3328
Mailing Address - Fax:505-214-5015
Practice Address - Street 1:1713 WELLSPRING AVE SE STE A
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4957
Practice Address - Country:US
Practice Address - Phone:505-738-3328
Practice Address - Fax:505-214-5015
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007178183500000X
NMMD2022-0654202D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No183500000XPharmacy Service ProvidersPharmacist