Healthcare Provider Details

I. General information

NPI: 1023544772
Provider Name (Legal Business Name): ROSE CHINWE UWAKWE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7721 ROCKYRIDGE DR
FRISCO TX
75035-8909
US

IV. Provider business mailing address

7721 ROCKYRIDGE DR
FRISCO TX
75035-8909
US

V. Phone/Fax

Practice location:
  • Phone: 469-767-1805
  • Fax:
Mailing address:
  • Phone: 469-767-1805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number918032
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: