Healthcare Provider Details

I. General information

NPI: 1457821258
Provider Name (Legal Business Name): NATHANIA ADU APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATHANIA LOUIS-PIERRE

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1926 SW GREEN OAKS BLVD
ARLINGTON TX
76017-2735
US

IV. Provider business mailing address

143 S GIBSON ST
MEDFORD WI
54451-1622
US

V. Phone/Fax

Practice location:
  • Phone: 817-472-5522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9391432
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9054
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: