Healthcare Provider Details

I. General information

NPI: 1174003065
Provider Name (Legal Business Name): CHUKWUNYERE FRANCIS NDUBUEZE MSC, CNP, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 NE 13TH ST
OKLAHOMA CITY OK
73104-5004
US

IV. Provider business mailing address

16712 VALLEY CRST
EDMOND OK
73012-6725
US

V. Phone/Fax

Practice location:
  • Phone: 405-201-7902
  • Fax:
Mailing address:
  • Phone: 405-201-7902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License NumberR0090174
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR0090174
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: