Healthcare Provider Details

I. General information

NPI: 1750901336
Provider Name (Legal Business Name): NNEKA A NLEMCHUKWU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4628 JETTY LN
HOUSTON TX
77072-1221
US

IV. Provider business mailing address

4628 JETTY LN
HOUSTON TX
77072-1221
US

V. Phone/Fax

Practice location:
  • Phone: 720-338-7465
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number844493
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: