NPI Code Detail JSON Logo

1710509740 NPI number — KELECHI MADUKA

NPI Number: 1710509740
Health Care Provider/Practitioner: KELECHI MADUKA

Information about “1710509740” NPI (KELECHI MADUKA) exists in 1710509740 in HTML format HTML  |  1710509740 in plain Text format TXT  |  1710509740 in PDF (Portable Document Format) PDF  |  1710509740 in an XML format XML  formats.

NPI Number : 1710509740 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1710509740",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MADUKA",
    "FirstName": "KELECHI",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4229 GLENHAVEN DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GARLAND",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75042-6120",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "469-209-3783",
    "MailingAddressFaxNumber": "972-918-5166",
    "FirstLinePracticeLocationAddress": "4229 GLENHAVEN DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GARLAND",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75042-6120",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "469-209-3783",
    "PracticeLocationAddressFaxNumber": "972-918-5166",
    "EnumerationDate": "05/13/2020",
    "LastUpdateDate": "05/13/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "163WA2000X",
        "TaxonomyName": "Administrator Registered Nurse",
        "LicenseNumber": "789766",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.