Individual
CHISOM C OKPARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 SANDSTONE CIR, JACKSON, TN 38305-2073
(731) 240-1695
Mailing address
30 SANDSTONE CIR, JACKSON, TN 38305-2073
(731) 240-1695
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
682845
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1096592
TX
Other
Enumeration date
10/06/2022
Last updated
03/21/2023
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