Provider Demographics
NPI:1295290419
Name:OKEKE, KATE
Entity type:Individual
Prefix:MRS
First Name:KATE
Middle Name:
Last Name:OKEKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 04 64TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11365
Mailing Address - Country:US
Mailing Address - Phone:917-539-3669
Mailing Address - Fax:
Practice Address - Street 1:188 04 64TH AVENUE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11365
Practice Address - Country:US
Practice Address - Phone:917-539-3669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332964164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse