Individual
IMMACULATE OKEYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7111 BOSQUE BLVD STE 303, WACO, TX 76710-4071
(254) 307-3997
(254) 300-9935
Mailing address
7111 BOSQUE BLVD STE 303, WACO, TX 76710-4071
(254) 307-3997
(254) 300-9935
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1056692
TX
Other
Enumeration date
10/29/2021
Last updated
03/08/2023
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