Provider Demographics
NPI:1023031978
Name:ONYEUKWU, NKECHI PAULINE (RN MSN FNP)
Entity Type:Individual
Prefix:MRS
First Name:NKECHI
Middle Name:PAULINE
Last Name:ONYEUKWU
Suffix:
Gender:F
Credentials:RN MSN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3814 GRANT STREET
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46408
Mailing Address - Country:US
Mailing Address - Phone:219-884-3447
Mailing Address - Fax:219-884-3512
Practice Address - Street 1:3814 GRANT STREET
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46408
Practice Address - Country:US
Practice Address - Phone:219-884-3447
Practice Address - Fax:219-884-3512
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001533A363L00000X
IL209.007219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200423230AMedicaid
TB5740Medicare ID - Type Unspecified
IN200423230AMedicaid