Provider Demographics
NPI:1275235681
Name:EPEAGBA, CHIZURUM (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CHIZURUM
Middle Name:
Last Name:EPEAGBA
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10442 APPALOOSA BAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-5862
Mailing Address - Country:US
Mailing Address - Phone:210-815-1275
Mailing Address - Fax:
Practice Address - Street 1:10442 APPALOOSA BAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-5862
Practice Address - Country:US
Practice Address - Phone:210-815-1275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF03230115363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily