Healthcare Provider Details

I. General information

NPI: 1144863473
Provider Name (Legal Business Name): NKEIRU OKECHUKWU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2019
Last Update Date: 10/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7107 IRONWOOD FOREST DR
HOUSTON TX
77083-1667
US

IV. Provider business mailing address

7107 IRONWOOD FOREST DR
HOUSTON TX
77083-1667
US

V. Phone/Fax

Practice location:
  • Phone: 832-462-9410
  • Fax:
Mailing address:
  • Phone: 832-462-9410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number917886
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: