Provider Demographics
NPI:1679243562
Name:OKEMWA, REUBEN NYAACHI (APRN)
Entity type:Individual
Prefix:MR
First Name:REUBEN
Middle Name:NYAACHI
Last Name:OKEMWA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1633 E KELTON LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-9193
Mailing Address - Country:US
Mailing Address - Phone:509-869-5118
Mailing Address - Fax:509-388-0540
Practice Address - Street 1:1633 E KELTON LN
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-9193
Practice Address - Country:US
Practice Address - Phone:509-869-5118
Practice Address - Fax:509-388-0540
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1049435363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty