Healthcare Provider Details

I. General information

NPI: 1568275493
Provider Name (Legal Business Name): KELECHI UKE APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 HARRY HINES BLVD
DALLAS TX
75235-7709
US

IV. Provider business mailing address

5200 HARRY HINES BLVD
DALLAS TX
75235-7709
US

V. Phone/Fax

Practice location:
  • Phone: 214-590-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1183107
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: