Healthcare Provider Details

I. General information

NPI: 1255479457
Provider Name (Legal Business Name): JOSEPHINE NDUAGU NWANKPA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 HARWIN DR. SUITE 215
HOUSTON TX
77036-7180
US

IV. Provider business mailing address

7111 HARWIN DR. SUITE 215
HOUSTON TX
77036-2143
US

V. Phone/Fax

Practice location:
  • Phone: 713-272-7273
  • Fax: 713-272-7276
Mailing address:
  • Phone: 713-272-7273
  • Fax: 713-272-7276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number621214
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: