Provider Demographics
NPI:1366118978
Name:OKURA, MICHIE Y (PA-C)
Entity type:Individual
Prefix:
First Name:MICHIE
Middle Name:Y
Last Name:OKURA
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Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:697 LOUISIANA DRIVE
Mailing Address - Street 2:DYESS AIR FORCE BASE
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79607-1367
Mailing Address - Country:US
Mailing Address - Phone:808-492-7251
Mailing Address - Fax:
Practice Address - Street 1:697 LOUISIANA DRIVE
Practice Address - Street 2:DYESS AFB
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79607-1367
Practice Address - Country:US
Practice Address - Phone:808-492-7251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2024-11-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant