Provider Demographics
NPI:1568654499
Name:NWOKO, PATRICIA ESEMONU (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ESEMONU
Last Name:NWOKO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 STATLER BEND DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-4933
Mailing Address - Country:US
Mailing Address - Phone:512-587-4654
Mailing Address - Fax:
Practice Address - Street 1:1107 STATLER BEND DR
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-4933
Practice Address - Country:US
Practice Address - Phone:512-587-4654
Practice Address - Fax:512-990-8013
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008324251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679411Medicare Oscar/Certification
TX67-9411Medicare PIN