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General NPI Number Information
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NPI Number | 1619776184
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Entity Type | Individual
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Provider Name | NKECHI VIVIAN EKEZIE
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Gender | Female
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 3840 HULEN ST
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City | FORT WORTH
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State | TX
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Zip | 76107-7277
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Country | US
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Telephone | 817-569-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 6212 THUNDERWING DR
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City | FORT WORTH
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State | TX
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Zip | 76179-1540
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Country | US
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Telephone | 817-768-0395
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1191633
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License Number State | TX
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