Provider Demographics
NPI:1023716776
Name:OKOLO, OBIOZOR
Entity type:Individual
Prefix:
First Name:OBIOZOR
Middle Name:
Last Name:OKOLO
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 1:4032 N 132ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-1838
Mailing Address - Country:US
Mailing Address - Phone:531-466-4506
Mailing Address - Fax:
Practice Address - Street 1:4032 N 132ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-1838
Practice Address - Country:US
Practice Address - Phone:531-466-4506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies