MEDICARE: ONYEKACHI BERNADETTE EMEREUWAONU APRN-CNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	854514	NV

General Provider Information

NPI Number	:	1578201265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ONYEKACHI BERNADETTE EMEREUWAONU APRN-CNP

Provider Business Mailing Address
First Line	:	6528 BLACK OAKS ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-2045
Country	:	US
Telephone Number	:	702-592-6219
Fax Number	:

Provider Business Practice Location Address
First Line	:	6528 BLACK OAKS ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-2045
Country	:	US
Telephone Number	:	702-592-6219
Fax Number	:

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

Provider Enumeration Date	:	05/24/2022
Last Update Date	:	05/24/2022

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