1235695008 NPI number — MRS. CATHERINE IJEOMA NNADOZIE

Table of content: MRS. CATHERINE IJEOMA NNADOZIE (NPI 1235695008)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235695008 NPI number — MRS. CATHERINE IJEOMA NNADOZIE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NNADOZIE
Provider First Name:
CATHERINE
Provider Middle Name:
IJEOMA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ONONIWU
Provider Other First Name:
CATHERINE
Provider Other Middle Name:
IJEOMA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
NURSE PRACTITIONER
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235695008
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5106 KATY CREEK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KILLEEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76549-6077
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-223-2496
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
590 MEDICAL CENTER ROAD FORT CAVAZOS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KILLEEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76544-6077
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-618-7727
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/15/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WP0807X , with the licence number:  797751 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: AP141252 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 797751 . This is a "TEXAS BOARD OF NURSING" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 2018087484 . This is a "ANCC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".