Healthcare Provider Details

I. General information

NPI: 1578859229
Provider Name (Legal Business Name): MIRIAM UZOAMAKA NNABUIHE APN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 HESTERS CROSSING RD
ROUND ROCK TX
78681-8018
US

IV. Provider business mailing address

6210 E HWY 290
AUSTIN TX
78723-1142
US

V. Phone/Fax

Practice location:
  • Phone: 512-244-9024
  • Fax: 512-406-7342
Mailing address:
  • Phone: 512-483-9596
  • Fax: 512-406-6216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP137466
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: