Provider Demographics
NPI:1396229498
Name:AMUNEKE, ALICE (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:
Last Name:AMUNEKE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 BERKOFF DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5505
Mailing Address - Country:US
Mailing Address - Phone:832-815-0857
Mailing Address - Fax:281-238-5014
Practice Address - Street 1:1730 BERKOFF DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5505
Practice Address - Country:US
Practice Address - Phone:832-815-0857
Practice Address - Fax:281-238-5014
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health