Provider Demographics
NPI:1558947671
Name:MADUH, JUDITH OGECHUKWU (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:OGECHUKWU
Last Name:MADUH
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 WADE BLVD
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5894
Mailing Address - Country:US
Mailing Address - Phone:972-668-3109
Mailing Address - Fax:972-668-3110
Practice Address - Street 1:8501 WADE BLVD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5894
Practice Address - Country:US
Practice Address - Phone:972-668-3109
Practice Address - Fax:972-668-3110
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1031693363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health