NPI Code Details Logo

NPI 1508366642

NPI 1508366642 : NWAMAKA LARVINE EMERUEM : VANCOUVER, WA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1508366642
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    NWAMAKA LARVINE EMERUEM
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/15/2018
-----------------------------------------------------
    Last Update Date     |    03/22/2022
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2512 E EVERGREEN BLVD 
-----------------------------------------------------
    City                 |    VANCOUVER
-----------------------------------------------------
    State                |    WA
-----------------------------------------------------
    Zip                  |    98661-4323
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    972-503-4109
-----------------------------------------------------
    Fax                  |    972-449-0500
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    402 W WHEATLAND RD STE 140 
-----------------------------------------------------
    City                 |    DUNCANVILLE
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    75116-4628
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    972-503-4109
-----------------------------------------------------
    Fax                  |    972-449-0500
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LP2300X
-----------------------------------------------------
    Taxonomy Name        |    Primary Care Nurse Practitioner
-----------------------------------------------------
    License Number       |    AP136592
-----------------------------------------------------
    License Number State |    TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    363LP0808X
-----------------------------------------------------
    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
    License Number       |    AP136592
-----------------------------------------------------
    License Number State |    TX
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.