Provider Demographics
NPI:1700074804
Name:OKPALA, BEATRICE OBIAGELI (RN, BSC OPTOMETRY)
Entity Type:Individual
Prefix:MRS
First Name:BEATRICE
Middle Name:OBIAGELI
Last Name:OKPALA
Suffix:
Gender:F
Credentials:RN, BSC OPTOMETRY
Other - Prefix:MISS
Other - First Name:BEATRICE
Other - Middle Name:OBIAGELI
Other - Last Name:OKAFOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HIGH SCHOOL DIPLOMA
Mailing Address - Street 1:1742 STONEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-8907
Mailing Address - Country:US
Mailing Address - Phone:608-834-6203
Mailing Address - Fax:
Practice Address - Street 1:1742 STONEHAVEN DR
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-8907
Practice Address - Country:US
Practice Address - Phone:608-834-6203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI152741-030163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health