Healthcare Provider Details

I. General information

NPI: 1720433865
Provider Name (Legal Business Name): IRENE IFEYINWA UKE FNP-C PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2016
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2033 MILITARY PKWY STE 402D
MESQUITE TX
75149-3670
US

IV. Provider business mailing address

2033 MILITARY PKWY STE 402D
MESQUITE TX
75149-3670
US

V. Phone/Fax

Practice location:
  • Phone: 469-373-2828
  • Fax: 469-373-2500
Mailing address:
  • Phone: 469-373-2828
  • Fax: 469-373-2500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP130753
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61441229
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP130753
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: