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General NPI Number Information
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NPI Number | 1710536388
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Entity Type | Individual
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Provider Name | CHIOMA JENNIFER OLUNKWA AGACNP
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Gender | Female
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 10/18/2025
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Provider Practice Location Address
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Address Line | METHODIST CHARLTON MEDICAL CENTER 3500 W WHEATLAND RD
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City | DALLAS
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State | TX
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Zip | 75237
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Country | US
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Telephone | 214-947-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 2203 LEWIS TRL
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-2273
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Country | US
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Telephone | 214-875-0818
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP143196
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License Number State | TX
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