Provider Demographics
NPI:1235695008
Name:NNADOZIE, CATHERINE IJEOMA
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:IJEOMA
Last Name:NNADOZIE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:IJEOMA
Other - Last Name:ONONIWU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:5106 KATY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-6077
Mailing Address - Country:US
Mailing Address - Phone:808-223-2496
Mailing Address - Fax:
Practice Address - Street 1:5106 KATY CREEK LN
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-6077
Practice Address - Country:US
Practice Address - Phone:808-223-2496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-15
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX797751163WP0807X
TXAP141252363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2018087484OtherANCC
TX797751OtherTEXAS BOARD OF NURSING