Provider Demographics
NPI:1336771799
Name:UKE, CYNTHIA NNENNA (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:NNENNA
Last Name:UKE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:NNENNA
Other - Last Name:UKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1908 POINTE LN E
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-4025
Mailing Address - Country:US
Mailing Address - Phone:915-487-9584
Mailing Address - Fax:
Practice Address - Street 1:2400 TRAWOOD DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-4168
Practice Address - Country:US
Practice Address - Phone:915-599-6735
Practice Address - Fax:915-629-7627
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-04
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX941569163W00000X
TX1121924363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse