1407370240 NPI number — MR. EMEKA LINUS CHIKWELU OKAFOR RN

Table of content: MR. EMEKA LINUS CHIKWELU OKAFOR RN (NPI 1407370240)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407370240 NPI number — MR. EMEKA LINUS CHIKWELU OKAFOR RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OKAFOR
Provider First Name:
EMEKA LINUS
Provider Middle Name:
CHIKWELU
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OKAFOR
Provider Other First Name:
LINUS EMEKA
Provider Other Middle Name:
CHIKWELU
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1407370240
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/02/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2608 87TH TRL N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN PARK
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55443-3742
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-222-4746
Provider Business Mailing Address Fax Number:
763-888-0075

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3675 124TH CIR NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COON RAPIDS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55433-1659
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-222-4746
Provider Business Practice Location Address Fax Number:
763-888-0075
Provider Enumeration Date:
08/02/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WH0200X , with the licence number:  157754-5 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1417342494 . This is a "HOME AND COMMUNITY BASED SERVICES" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".