Provider Demographics
NPI:1497098883
Name:NWAOKWU, LEO IWE (FNP)
Entity Type:Individual
Prefix:
First Name:LEO
Middle Name:IWE
Last Name:NWAOKWU
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:LEO
Other - Middle Name:IWE
Other - Last Name:NWAOKWU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:18749 MARSH LN APT 213
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-3506
Mailing Address - Country:US
Mailing Address - Phone:512-287-0444
Mailing Address - Fax:
Practice Address - Street 1:1650 GALISTEO ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4747
Practice Address - Country:US
Practice Address - Phone:512-287-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF07191726363LF0000X
NM60305363LF0000X
NY651848163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health