Provider Demographics
NPI:1063944742
Name:UKWU, CHIDINMA OBY (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:CHIDINMA
Middle Name:OBY
Last Name:UKWU
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:CHIDINMA
Other - Middle Name:OBY
Other - Last Name:EZEANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2828 HAYES RD
Mailing Address - Street 2:APT 1221
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-6633
Mailing Address - Country:US
Mailing Address - Phone:832-382-4504
Mailing Address - Fax:
Practice Address - Street 1:2828 HAYES RD
Practice Address - Street 2:APT 1221
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-6633
Practice Address - Country:US
Practice Address - Phone:832-382-4504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX777155163WP0808X
TXAP131761363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health