Provider Demographics
NPI:1316507585
Name:INYANG, MAGDALENE ETUAJE (NP)
Entity type:Individual
Prefix:
First Name:MAGDALENE
Middle Name:ETUAJE
Last Name:INYANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9802 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77016-3702
Mailing Address - Country:US
Mailing Address - Phone:832-937-5917
Mailing Address - Fax:
Practice Address - Street 1:1518 CRESCENT OAK DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4577
Practice Address - Country:US
Practice Address - Phone:832-971-5848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-19
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141843363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily