Healthcare Provider Details

I. General information

NPI: 1801617667
Provider Name (Legal Business Name): NELLIE NJOKU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7131 W 135TH ST
OVERLAND PARK KS
66223-1238
US

IV. Provider business mailing address

8800 RAYTOWN RD UNIT 11535
KANSAS CITY MO
64138-6202
US

V. Phone/Fax

Practice location:
  • Phone: 913-412-2477
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-84504-071
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2024042780
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: