Provider Demographics
NPI:1700554763
Name:OKWUEZE, SOLOMON SOROIBE (PMHNP-B)
Entity type:Individual
Prefix:
First Name:SOLOMON
Middle Name:SOROIBE
Last Name:OKWUEZE
Suffix:
Gender:M
Credentials:PMHNP-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 COLONY VILLAGE WAY APT 402
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23237-3337
Mailing Address - Country:US
Mailing Address - Phone:804-967-4850
Mailing Address - Fax:
Practice Address - Street 1:10300 COLONY VILLAGE WAY APT 402
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23237-3337
Practice Address - Country:US
Practice Address - Phone:804-967-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182575363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health