Healthcare Provider Details

I. General information

NPI: 1770250227
Provider Name (Legal Business Name): CHIDINMA OJINIKA NJOKU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 LAKEVIEW PKWY
ROWLETT TX
75088-3367
US

IV. Provider business mailing address

3430 LAKEVIEW PKWY
ROWLETT TX
75088-3367
US

V. Phone/Fax

Practice location:
  • Phone: 972-475-2597
  • Fax:
Mailing address:
  • Phone: 972-475-2597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1010477
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: