Provider Demographics
NPI:1962134312
Name:NWOSU, NATHANIEL MADUAKOLAM (APRN-CNP)
Entity type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:MADUAKOLAM
Last Name:NWOSU
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11347 HENDERSON DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8852
Mailing Address - Country:US
Mailing Address - Phone:646-530-2521
Mailing Address - Fax:
Practice Address - Street 1:11347 HENDERSON DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-8852
Practice Address - Country:US
Practice Address - Phone:646-530-2521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1073107363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health