Provider Demographics
NPI:1881463719
Name:EKE, OGECHI (BSN, RN)
Entity type:Individual
Prefix:MS
First Name:OGECHI
Middle Name:
Last Name:EKE
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:OGECHI
Other - Middle Name:MARY
Other - Last Name:EKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:143 COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121-3154
Mailing Address - Country:US
Mailing Address - Phone:857-210-4361
Mailing Address - Fax:
Practice Address - Street 1:143 COLUMBIA RD APT 11
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02121-3124
Practice Address - Country:US
Practice Address - Phone:857-210-4361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2386686163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice