Provider Demographics
NPI:1063924108
Name:CHAMA, HUMPHREY ONYEONORO (MSN, ARPN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HUMPHREY
Middle Name:ONYEONORO
Last Name:CHAMA
Suffix:
Gender:M
Credentials:MSN, ARPN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 683
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75030-0683
Mailing Address - Country:US
Mailing Address - Phone:214-282-4548
Mailing Address - Fax:214-432-7535
Practice Address - Street 1:7413 KALLAN DR
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-3844
Practice Address - Country:US
Practice Address - Phone:214-282-4548
Practice Address - Fax:214-432-7535
Is Sole Proprietor?:No
Enumeration Date:2017-10-30
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1032682363LP0808X
WAAP61356809363LP0808X
FLAPRN11032161363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health