Healthcare Provider Details

I. General information

NPI: 1023993979
Provider Name (Legal Business Name): FREDA UKEKA APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2025
Last Update Date: 08/09/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

928 23RD AVE
BELLWOOD IL
60104-2501
US

IV. Provider business mailing address

928 23RD AVE
BELLWOOD IL
60104-2501
US

V. Phone/Fax

Practice location:
  • Phone: 206-639-7228
  • Fax:
Mailing address:
  • Phone: 206-639-7228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61671968
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: