Provider Demographics
NPI:1164096566
Name:ADWEDAA, MICHAELINE (APRN, MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHAELINE
Middle Name:
Last Name:ADWEDAA
Suffix:
Gender:F
Credentials:APRN, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16261 FM 529 RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1433
Mailing Address - Country:US
Mailing Address - Phone:832-961-7032
Mailing Address - Fax:
Practice Address - Street 1:16261 FM 529 RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-1433
Practice Address - Country:US
Practice Address - Phone:832-961-7032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1036240363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily