Healthcare Provider Details

I. General information

NPI: 1003225541
Provider Name (Legal Business Name): NICHOLAS CHINONSO ATUMAH RN,BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2014
Last Update Date: 10/21/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 WATER GARDEN CIRCLE LITTLE ELM
TEXAS TX
75044-5624
US

IV. Provider business mailing address

904 WATER GARDEN CIRCLE LITTLE ELM
TEXAS TX
75044-5624
US

V. Phone/Fax

Practice location:
  • Phone: 214-384-2949
  • Fax: 469-379-2681
Mailing address:
  • Phone: 214-384-2949
  • Fax: 469-379-2681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number823233
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number823233
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number823233
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number823233
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: