Healthcare Provider Details

I. General information

NPI: 1427607100
Provider Name (Legal Business Name): NANU OGUNYOKU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 SILKTAIL CT
RICHMOND TX
77407-4200
US

IV. Provider business mailing address

25807 WESTHEIMER PKWY STE 422
KATY TX
77494-5369
US

V. Phone/Fax

Practice location:
  • Phone: 713-581-7961
  • Fax:
Mailing address:
  • Phone: 832-228-3181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number873653
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberC-APN.0003070-C-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP142893
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: