Provider Demographics
NPI:1811728009
Name:OKEKE, LOIS CHINYERE
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:CHINYERE
Last Name:OKEKE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LOIS
Other - Middle Name:CHINYERE
Other - Last Name:ALABUIKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4612 SUTHERLAND CIR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-6103
Mailing Address - Country:US
Mailing Address - Phone:301-385-5570
Mailing Address - Fax:
Practice Address - Street 1:4612 SUTHERLAND CIR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-6103
Practice Address - Country:US
Practice Address - Phone:301-385-5570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1010640364SP0810X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Family