Provider Demographics
NPI:1093290694
Name:CHUKWUMA, STELLA OGOCHUKWU
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:OGOCHUKWU
Last Name:CHUKWUMA
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 1:4407 MESA CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5437
Mailing Address - Country:US
Mailing Address - Phone:832-646-4232
Mailing Address - Fax:
Practice Address - Street 1:4407 MESA CROSSING LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5437
Practice Address - Country:US
Practice Address - Phone:832-646-4232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX688825163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics