MEDICARE: ASHLEY NYAKUNDI FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	892849	TX
2	363L00000X	Nurse Practitioner	1153794	TX

General Provider Information

NPI Number	:	1144047804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY NYAKUNDI FNP-BC

Provider Business Mailing Address
First Line	:	13410 BRIAR FOREST DR STE 190
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-2393
Country	:	US
Telephone Number	:	281-771-1144
Fax Number	:

Provider Business Practice Location Address
First Line	:	13410 BRIAR FOREST DR STE 190
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-2393
Country	:	US
Telephone Number	:	281-771-1144
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	02/24/2025

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