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General NPI Number Information
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NPI Number | 1932768090
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Entity Type | Organization
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Legal Business Name | NKECHI EZEMA, PLLC
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 3839 MCKINNEY AVE STE 155-2470
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City | DALLAS
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State | TX
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Zip | 75204-1413
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Country | US
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Telephone | 214-483-1993
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Fax | 214-301-3171
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Provider Business Mailing Address
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Address Line | 2900 W PARK ROW DR STE C
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City | PANTEGO
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State | TX
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Zip | 76013-2047
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Country | US
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Telephone | 214-483-1993
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Fax | 214-301-3171
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Authorized Official
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Title or Position | OWNER
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Name | NKECHI F EZEMA
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Credential | PMHNP-BC
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Telephone | 214-483-1993
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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 |
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License Number State |
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