Healthcare Provider Details

I. General information

NPI: 1235695008
Provider Name (Legal Business Name): MRS. CATHERINE IJEOMA NNADOZIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHERINE IJEOMA ONONIWU NURSE PRACTITIONER

II. Dates (important events)

Enumeration Date: 02/15/2019
Last Update Date: 03/17/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 MEDICAL CENTER ROAD FORT CAVAZOS
KILLEEN TX
76544-6077
US

IV. Provider business mailing address

5106 KATY CREEK LN
KILLEEN TX
76549-6077
US

V. Phone/Fax

Practice location:
  • Phone: 254-618-7727
  • Fax:
Mailing address:
  • Phone: 808-223-2496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number797751
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP141252
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: