Provider Demographics
NPI:1578867966
Name:OKWUOSAH, CORDELIA C (FNP-BC)
Entity type:Individual
Prefix:
First Name:CORDELIA
Middle Name:C
Last Name:OKWUOSAH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CORDELIA
Other - Middle Name:CHINELO
Other - Last Name:DOWDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3408 S ATLANTIC AVE # 1012
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:32118-6311
Mailing Address - Country:US
Mailing Address - Phone:386-227-7580
Mailing Address - Fax:619-367-0419
Practice Address - Street 1:3408 S ATLANTIC AVE # 1012
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32118-6311
Practice Address - Country:US
Practice Address - Phone:386-227-7580
Practice Address - Fax:619-367-0419
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-29
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000816363LF0000X
CA19862363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1578867966OtherNPI