Provider Demographics
NPI:1811265952
Name:EMOKPAE, IYORE J (RN)
Entity type:Individual
Prefix:MR
First Name:IYORE
Middle Name:J
Last Name:EMOKPAE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 CLUB TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-4625
Mailing Address - Country:US
Mailing Address - Phone:917-238-3943
Mailing Address - Fax:
Practice Address - Street 1:710 WILLOWBRANCH LN
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-1319
Practice Address - Country:US
Practice Address - Phone:817-975-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-04
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH375009163WH0200X
TX144797363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH0200XNursing Service ProvidersRegistered NurseHome Health