Provider Demographics
NPI:1881434066
Name:OKAFOR, ONYINYECHUKWU CRYSTAL
Entity type:Individual
Prefix:
First Name:ONYINYECHUKWU
Middle Name:CRYSTAL
Last Name:OKAFOR
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 1:13794 W WADDELL RD # 203-152
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-8499
Mailing Address - Country:US
Mailing Address - Phone:602-777-2194
Mailing Address - Fax:
Practice Address - Street 1:13794 W WADDELL RD # 203-152
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-8499
Practice Address - Country:US
Practice Address - Phone:602-777-2194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
AZ304285376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No251E00000XAgenciesHome Health