Provider Demographics
NPI:1508236753
Name:NWOKOLO, DEBORAH OLUDAMILOLA
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:OLUDAMILOLA
Last Name:NWOKOLO
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 1:333 COMMERCE ST STE 700
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-1835
Mailing Address - Country:US
Mailing Address - Phone:832-786-4970
Mailing Address - Fax:855-737-5542
Practice Address - Street 1:5444 WESTHEIMER RD STE 1000
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5318
Practice Address - Country:US
Practice Address - Phone:844-462-2677
Practice Address - Fax:855-737-5542
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily