MEDICARE: CHINWE M NWORA

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	363LF0000X	Family Nurse Practitioner	AP145009	TX

General Provider Information

NPI Number	:	1972135804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHINWE M NWORA

Provider Business Mailing Address
First Line	:	5915 JASPER TERRACE LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-2221
Country	:	US
Telephone Number	:	573-359-4263
Fax Number	:

Provider Business Practice Location Address
First Line	:	5915 JASPER TERRACE LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-2221
Country	:	US
Telephone Number	:	573-359-4263
Fax Number	:

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

Provider Enumeration Date	:	02/08/2020
Last Update Date	:	02/08/2020

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Directions to “ CHINWE M NWORA ” Practice Location

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