Provider Demographics
NPI:1578323671
Name:OGBUEHI, KELECHI N (PMHNP)
Entity Type:Individual
Prefix:
First Name:KELECHI
Middle Name:N
Last Name:OGBUEHI
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 WILSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-8672
Mailing Address - Country:US
Mailing Address - Phone:469-867-1166
Mailing Address - Fax:
Practice Address - Street 1:1203 WILSHIRE CT
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8672
Practice Address - Country:US
Practice Address - Phone:469-867-1166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1141810363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health