Provider Demographics
NPI:1992153654
Name:HARRISON, NNEKA IKEAKOR
Entity type:Individual
Prefix:
First Name:NNEKA
Middle Name:IKEAKOR
Last Name:HARRISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21622 COZY HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-5666
Mailing Address - Country:US
Mailing Address - Phone:214-462-0459
Mailing Address - Fax:
Practice Address - Street 1:21622 COZY HOLLOW LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-5666
Practice Address - Country:US
Practice Address - Phone:214-462-0459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX771207363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily