Provider Demographics
NPI:1437028750
Name:KALU, NNEKA VANESSA
Entity type:Individual
Prefix:
First Name:NNEKA
Middle Name:VANESSA
Last Name:KALU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 ELM FALLS PL
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-2144
Mailing Address - Country:US
Mailing Address - Phone:469-655-0555
Mailing Address - Fax:469-655-0555
Practice Address - Street 1:2207 ELM FALLS PL
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-2144
Practice Address - Country:US
Practice Address - Phone:469-655-0555
Practice Address - Fax:469-655-0555
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1216839363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty