Provider Demographics
NPI:1124506944
Name:EKUMA, ROSELINE (FNP)
Entity type:Individual
Prefix:
First Name:ROSELINE
Middle Name:
Last Name:EKUMA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24531 TRIBECA LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-2694
Mailing Address - Country:US
Mailing Address - Phone:832-549-1780
Mailing Address - Fax:
Practice Address - Street 1:8313 SOUTHWEST FWY STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1612
Practice Address - Country:US
Practice Address - Phone:281-704-3836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily