Provider Demographics
NPI:1881786028
Name:OKEREKE, CHIOMA U (DNP, NP-BC)
Entity type:Individual
Prefix:DR
First Name:CHIOMA
Middle Name:U
Last Name:OKEREKE
Suffix:
Gender:F
Credentials:DNP, NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 AUSTELL RD SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-4537
Mailing Address - Country:US
Mailing Address - Phone:678-213-3137
Mailing Address - Fax:678-213-3139
Practice Address - Street 1:2317 AUSTELL RD SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30008-4537
Practice Address - Country:US
Practice Address - Phone:678-213-3137
Practice Address - Fax:678-213-3139
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN113110NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10033463OtherAMERIGROUP
1502260OtherLOUISIANNA STATE MEDICAID
GA931772211BMedicaid
GA50BBJWTMedicare ID - Type Unspecified
GA931772211BMedicaid