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General NPI Number Information
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NPI Number | 1912274622
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Entity Type | Individual
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Provider Name | NNEKA CHINELO JON-UBABUCO PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/23/2011
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 220 N PARK BLVD SUITE 114
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City | GRAPEVINE
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State | TX
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Zip | 76051-6987
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Country | US
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Telephone | 817-488-7771
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Fax | 817-488-7774
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Provider Business Mailing Address
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Address Line | 220 N PARK BLVD SUITE 114
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City | GRAPEVINE
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State | TX
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Zip | 76051-6987
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Country | US
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Telephone | 817-488-7771
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Fax | 817-488-7774
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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 | AP121280
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11041402
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License Number State | FL
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