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General NPI Number Information
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NPI Number | 1912560954
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Entity Type | Individual
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Provider Name | SUSSAN C NWOGWUGWU PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 04/26/2025
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Provider Practice Location Address
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Address Line | 715 N FIELDER RD
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City | ARLINGTON
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State | TX
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Zip | 76012-4695
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Country | US
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Telephone | 682-220-9615
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Fax |
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Provider Business Mailing Address
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Address Line | 7809 SALTON LN
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City | ARLINGTON
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State | TX
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Zip | 76001-5901
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Country | US
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Telephone | 213-984-8478
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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 | 95021812
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License Number State | CA
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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 | AP141239
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License Number State | TX
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