Healthcare Provider Details

I. General information

NPI: 1770273526
Provider Name (Legal Business Name): NNEKA CYNTHIA EJIKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2303 SWEETWOOD CT
FULSHEAR TX
77423-2971
US

IV. Provider business mailing address

2303 SWEETWOOD CT
FULSHEAR TX
77423-2971
US

V. Phone/Fax

Practice location:
  • Phone: 281-804-0465
  • Fax:
Mailing address:
  • Phone: 281-804-0465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61439131
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1114128
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: