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NPI Code Detail

MEDICARE: MRS. OGECHI KATHERINE NEBEOLISA

MEDICARE: MRS. OGECHI KATHERINE NEBEOLISA
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
1363LF0000XFamily Nurse PractitionerF11190555TX
2363LP0808XPsychiatric/Mental Health Nurse Practitioner1074742TX

General Provider Information

NPI Number : 1588201891
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. OGECHI KATHERINE NEBEOLISA
Provider Business Mailing Address
First Line : 201 KINGWOOD MEDICAL DR STE A450
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-6027
Country : US
Telephone Number : 832-701-0283
Fax Number :
Provider Business Practice Location Address
First Line : 201 KINGWOOD MEDICAL DR STE A450
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-6027
Country : US
Telephone Number : 832-701-0283
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2019
Last Update Date : 08/04/2023

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Directions to “ MRS. OGECHI KATHERINE NEBEOLISA ” Practice Location

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