1710224647 NPI number — MRS. CAROLINE CHIOMA UKACHUKWU NURSE PRACTITIONER

Table of content: MRS. CAROLINE CHIOMA UKACHUKWU NURSE PRACTITIONER (NPI 1710224647)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710224647 NPI number — MRS. CAROLINE CHIOMA UKACHUKWU NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UKACHUKWU
Provider First Name:
CAROLINE
Provider Middle Name:
CHIOMA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
UKACHUKWU
Provider Other First Name:
CAROLINE
Provider Other Middle Name:
CHIOMA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, MSN,ACNP-BC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1710224647
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6565 FANNIN ST. MGJ. SUIT 11,
Provider Second Line Business Mailing Address:
THE METHODIST HOSPITAL MARY GIBBS
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-441-1032
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6565 FANNIN ST. MGJ. SUIT 11
Provider Second Line Business Practice Location Address:
THE METHODIST HOSPITAL, MARY GIBBS
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-441-1032
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/11/2013

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: 275N00000X , with the licence number:  578560 , 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)





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