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General NPI Number Information
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NPI Number | 1689261679
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Entity Type | Individual
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Provider Name | NINA EZINNE NWOKO NP
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Gender | Female
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Dates
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Enumeration Date | 12/24/2020
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 1055 N CURTIS RD
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City | BOISE
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State | ID
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Zip | 83706-1309
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Country | US
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Telephone | 208-302-2000
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Fax | 208-302-2055
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Provider Business Mailing Address
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Address Line | 1920 GRASSMERE LN APT 1623
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City | MCKINNEY
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State | TX
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Zip | 75071-8542
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Country | US
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Telephone | 512-221-5754
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209030132
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1021680
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11035264
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 78791
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1021680
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024191331
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License Number State | VA
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