Provider Demographics
NPI:1417622028
Name:UGWU, GABERLIA NKIRU (FNP)
Entity Type:Individual
Prefix:
First Name:GABERLIA
Middle Name:NKIRU
Last Name:UGWU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9511 OLD QUARRY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-3967
Mailing Address - Country:US
Mailing Address - Phone:210-334-1377
Mailing Address - Fax:
Practice Address - Street 1:12980 BANDERA RD
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-4098
Practice Address - Country:US
Practice Address - Phone:210-372-0386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1033823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily