Provider Demographics
NPI:1588153761
Name:EZEH, JULIET EKPEREAMAKA (FNP)
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:EKPEREAMAKA
Last Name:EZEH
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 1:19714 HERON SHADOW CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4102
Mailing Address - Country:US
Mailing Address - Phone:832-208-7145
Mailing Address - Fax:
Practice Address - Street 1:19714 HERON SHADOW CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4102
Practice Address - Country:US
Practice Address - Phone:832-208-7145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132696363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily