Provider Demographics
NPI:1033815014
Name:ISENALUMHE, AKHERE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:AKHERE
Middle Name:
Last Name:ISENALUMHE
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0443
Mailing Address - Country:US
Mailing Address - Phone:972-533-5136
Mailing Address - Fax:
Practice Address - Street 1:3012 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-0443
Practice Address - Country:US
Practice Address - Phone:972-533-5136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1096401363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health