Provider Demographics
NPI:1932732138
Name:OKELLO, CYNTHIA AYOKI (CRNA, DNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:AYOKI
Last Name:OKELLO
Suffix:
Gender:F
Credentials:CRNA, DNP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:AYOKI
Other - Last Name:OKECH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA, DNP
Mailing Address - Street 1:9000 DEE LN APT 9214
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-8845
Mailing Address - Country:US
Mailing Address - Phone:845-309-9248
Mailing Address - Fax:
Practice Address - Street 1:255 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1763
Practice Address - Country:US
Practice Address - Phone:484-565-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-15
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19338800163WC0200X
PARN691633163WC0200X
PA131856367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine