Provider Demographics
NPI:1477046654
Name:CHUKWUOCHA, EZINNE BLESSING (NP)
Entity Type:Individual
Prefix:
First Name:EZINNE
Middle Name:BLESSING
Last Name:CHUKWUOCHA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EZINNE
Other - Middle Name:BLESSING
Other - Last Name:CHUKWUOCHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:5015 LARK CREEK CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3866
Mailing Address - Country:US
Mailing Address - Phone:832-891-1998
Mailing Address - Fax:
Practice Address - Street 1:5015 LARK CREEK CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3866
Practice Address - Country:US
Practice Address - Phone:832-891-1998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137646363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP137646OtherFAMILY CLINIC, INSURANCE