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General NPI Number Information
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NPI Number | 1710535398
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Entity Type | Individual
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Provider Name | EBELECHUKWU EKWENUGO PMHNP
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Gender | Female
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 616 JAGERA WAY
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City | ARLINGTON
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State | TX
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Zip | 76002-4582
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Country | US
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Telephone | 682-521-5224
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Fax |
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Provider Business Mailing Address
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Address Line | 616 JAGERA WAY
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City | ARLINGTON
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State | TX
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Zip | 76002-4582
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Country | US
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Telephone | 682-521-5224
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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 | 10022581
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP144089
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License Number State | TX
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